Common Contracts
3 similar Psychotherapist-Patient Services Agreement contracts
THE CHRYSALIS GROUP INC.Psychotherapist-Patient Services Agreement • October 28th, 2020
Welcome to my practice. This Agreement contains important information about my professional services and business policies. When you sign this document, it will also represent an agreement between us. You may revoke this Agreement in writing at any time. In addition, The Health Insurance Portability and Accountability Act (HIPAA), a new federal law, requires that I provide you with a Notice of Privacy Practices and that I obtain your signature acknowledging that I have provided you with this information. Those Privacy Practices appear at the end of this document and constitute a part of this agreement. You will receive a copy to keep at the end of our first session.
THE CHRYSALIS GROUP INC.Psychotherapist-Patient Services Agreement • October 12th, 2020
Joanne Boyd Irving, Ph.D.Psychotherapist-Patient Services Agreement • September 23rd, 2017
Welcome to my practice. This Agreement contains important information about my professional services and business policies. When you sign this document, it will also represent an agreement between us. You may revoke this Agreement in writing at any time. In addition, The Health Insurance Portability and Accountability Act, a new federal law, requires that I provide you with a Notice of Privacy Practices and that I obtain your signature acknowledging that I have provided you with this information. Those Privacy Practices appear at the end of this document and constitute a part of this agreement and you will receive a copy at the end of our first session.
