Common Contracts
1 similar Informed Consent contracts
Psychiatric Wellness Center 15 Constitution Drive, Suite 1A Bedford, NH 03110Informed Consent • November 21st, 2020
Welcome to the Psychiatric Wellness Center. This document (the Agreement) contains important information about our professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and patient rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. HIPAA requires that your provider gives you a Notice of Privacy Practices (the Notice) which you will receive with this agreement, for the use and disclosure of PHI for treatment, payment and health care operations. The Notice explains HIPAA and its application to your personal health information in greater detail. The law requires that your provider obtains your signature acknowledging that your provider has provided you with this information at the end of the first session. Although these documents are lo
