Common Contracts
2 similar Psychotherapist-Patient Services Agreement contracts
LESLIE H. KERN, Ph.D. CLINICAL PSYCHOLOGISTPsychotherapist-Patient Services Agreement • October 15th, 2022
Welcome to my practice. This document contains important information about my professional services and business policies. Following this document is a second document that contains 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 for use and disclosure of PHI. The Notice explains HIPAA and its application to your personal health information in greater detail. The law requires that I obtain your signature acknowledging that I have provided you with this information. Although this docwnent is long and sometimes complex, it is necessary for me to provide you with this information in order to comply with federal regulations. We can discuss any questions you have about thi
LESLIE H. KERN, Ph.D. CLINICAL PSYCHOLOGISTPsychotherapist-Patient Services Agreement • January 3rd, 2022
Welcome to my practice. This document contains important information about my professional services and business policies. Following this document is a second document that contains 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 for use and disclosure of PHI. The Notice explains HIPAA and its application to your personal health information in greater detail. The law requires that I obtain your signature acknowledging that I have provided you with this information. Although this document is long and sometimes complex, it is necessary for me to provide you with this information in order to comply with federal regulations. We can discuss any questions you have about thi
