Common Contracts
2 similar Psychologist-Client Services Agreement contracts
PSYCHOLOGIST- CLIENT SERVICES AGREEMENTPsychologist-Client Services Agreement • May 26th, 2020
Welcome to Breakthru Counseling and Consulting, P.C. (“BCC”), the psychological counseling practice of Dr. Quincy L. Warner. This document contains important information about BCC’s professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and patient (“client”) rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. HIPAA requires that BCC provide you with a Notice of Privacy Practices (“Notice”) for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which accompanies this Agreement, explains HIPAA and its application to your personal health information in greater detail. The law requires that BCC obtain your signature acknowledging that BCC has provided you with this information. Although these documents
PSYCHOLOGIST- CLIENT SERVICES AGREEMENTPsychologist-Client Services Agreement • February 18th, 2020
Welcome to Breakthru Counseling and Consulting, P.C. (“BCC”), the psychological counseling practice of Dr. Quincy L. Warner. This document contains important information about BCC’s professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and patient (“client”) rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. HIPAA requires that BCC provide you with a Notice of Privacy Practices (“Notice”) for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which accompanies this Agreement, explains HIPAA and its application to your personal health information in greater detail. The law requires that BCC obtain your signature acknowledging that BCC has provided you with this information at this session. Although
