Common Contracts
1 similar Services Agreement contracts
Psychologist-Patient Services AgreementServices Agreement • August 23rd, 2014
Welcome! This document contains important information about my professional services and business policies. This document also contains a brief summary of 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). In compliance with HIPAA, I am also providing you with a Notice of Privacy Practices which explains this in much greater detail. It is very important that you read this document carefully, and we can discuss any questions you have at any time. After reviewing this information, please sign this form, which constitutes an agreement between us. You may revoke this Agreement in writing at any time.
