Common Contracts
1 similar Psychotherapy Service Agreement contracts
PSYCHOTHERAPY SERVICE AGREEMENT FOR THE TREATMENT OF CHILD & ADOLESCENT CLIENTSPsychotherapy Service Agreement • September 23rd, 2020
Welcome to my practice. This document contains important information about my professional services and business policies. It also contains information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law providing privacy protections and client rights regarding 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 offer you with a Notice of Privacy Practices for use and disclosure of PHI for treatment, payment and health care operations. This explains HIPAA and its application to your personal health information. The law requires that I obtain your signature acknowledging that I have provided you this information by the end of this session. It is very important that you read them carefully before our next session. We can discuss any questions you have at that time. When you sign this, it will also represent an agreement between us. You may revoke th
