Common Contracts
1 similar Services Agreement contracts
Psychotherapist-Patient Services AgreementServices Agreement • August 30th, 2016
This document contains important information regarding my therapy services, practices, and confidentiality policies. This includes information on the Health Insurance Portability and Accountability Act (HIPAA), which is a federal law that provides protection over identifiable patient health information. I have included key elements regarding your rights as a client under this law as well as a summary of when your information may be disclosed. If you have further questions about this, please feel free to discuss them with me at any time. You are also welcome to find further information online; one useful website for this is: <http://www.hhs.gov/ocr/privacy/>. By signing this agreement, you will be acknowledging receipt of this information as well as representing an agreement between us. You can revoke this agreement in writing at any time. That revocation will be binding on me unless I have taken action in reliance on it; if there are obligations imposed on me by your health insurer in
