Common Contracts
1 similar Psychotherapist-Client Services Agreement contracts
PSYCHOTHERAPIST-CLIENT SERVICES AGREEMENT DISCLOSURE STATEMENTPsychotherapist-Client Services Agreement • January 12th, 2022
Welcome to my practice. This document (the Agreement) contains important information about my professional services and business policies. This document also contains summary information about the Health Insurance Portability and Accountability Act (HIPPA), a federal law that provides privacy protections and client rights regarding the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. In addition, HIPPA requires that I provide you with a Notice of Privacy Practices (the Notice) regarding formal disclosure of PHI for treatment, payment, and health care operations. The Notice, which is attached to this Agreement, explains HIPPA and its application to your personal health information in formal detail. The law requires that, as soon as possible (first or second session), I obtain your signature acknowledging that I have provided you with this information. Although these documents are long and sometimes comp
