Common Contracts
3 similar Client Information and Services Agreement contracts
ContractClient Information and Services Agreement • November 8th, 2024
Confidentiality and Records: As a Board Certified Behavior Analyst at the Monocacy Start Center, I offer services without regard to age, race, gender, or religious affiliation. While I may discuss you or your child’s care with other treating providers at Monocacy Start Center in order to provide you with the most comprehensive care possible, I will not discuss treatment or release information outside of Monocacy Start Center without your written permission. I keep secure records of treatment as required by the State of Maryland. Note: state law limits confidentiality and we are mandated to report any suspected child/elder abuse or harmful intentions. We also are required to make reasonable efforts to keep our clients safe if they become suicidal.
ContractClient Information and Services Agreement • December 19th, 2022
Confidentiality and Records: As a Board Certified Behavior Analyst at the Monocacy Start Center, I offer services without regard to age, race, gender, or religious affiliation. While I may discuss you or your child’s care with other treating providers at Monocacy Start Center in order to provide you with the most comprehensive care possible, I will not discuss treatment or release information outside of Monocacy Start Center without your written permission. I keep secure records of treatment as required by the State of Maryland. Note: state law limits confidentiality and we are mandated to report any suspected child/elder abuse or harmful intentions. We also are required to make reasonable efforts to keep our clients safe if they become suicidal.
ContractClient Information and Services Agreement • December 19th, 2022
Confidentiality and Records: As a Board Certified Behavior Analyst at the Monocacy Start Center, I offer services without regard to age, race, gender, or religious affiliation. While I may discuss you or your child’s care with other treating providers at Monocacy Start Center in order to provide you with the most comprehensive care possible, I will not discuss treatment or release information outside of Monocacy Start Center without your written permission. I keep secure records of treatment as required by the State of Maryland. Note: state law limits confidentiality and we are mandated to report any suspected child/elder abuse or harmful intentions. We also are required to make reasonable efforts to keep our clients safe if they become suicidal.
