Common Contracts
1 similar Psychotherapist-Patient Services Agreement contracts
John R. Jordan, Ph.D.Psychotherapist-Patient Services Agreement • September 2nd, 2024
Thank-you for contacting me about my services. This document contains information about my 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 I provide you with a Notice of Privacy Practices (the Notice) for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which accompanies this Agreement, explains HIPAA and its application to your personal health information. The law requires that I obtain your signature acknowledging that I have provided you with this information. Although these documents are long and sometimes complex, it is important that you read them. We can discuss any questions you have after you have
