Common Contracts
1 similar Client Confidentiality Agreement contracts
Terms of Acknowledgement and Agreement for Center and Community-Based Services:Client Confidentiality Agreement • December 22nd, 2021
You acknowledge and understand that by agreeing to receive center-based or community-based services, you also agree to the release of the following private health information (PHI) due to the potential of others* being present in the service delivery vicinity (center or community). PHI released may include, but is not limited to:
