Common Contracts

2 similar null contracts

Policies, Consent, and Agreement Form
December 6th, 2020
  • Filed
    December 6th, 2020

This form is in addition to the regular Therapy, Policies, Agreement and Consent Form and Notice of Privacy Practices for Protected Health Information commonly known as HIPAA. You must sign both in order to participate in Technology Assisted Counseling (TAC) sessions. TAC incorporates email, phone and video counseling. Prior to engage in TAC an assessment/consultation will be done to assure that TAC is an appropriate form of counseling. This is to inform you about what you can expect regarding your participation in TAC counseling.

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Policies, Consent, and Agreement Form
November 13th, 2017
  • Filed
    November 13th, 2017

This form is in addition to the regular Therapy, Policies, Agreement and Consent Form. You must sign both in order to participate in Technology Assisted Counseling (TAC) sessions. TAC incorporates email, phone and video counseling. Prior to engage in TAC an assessment/consultation will be done to assure that TAC is an appropriate form of counseling. This is to inform you about what you can expect regarding your participation in TAC counseling.

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