Common Contracts
2 similar Psychiatrist-Patient/Client Services Agreement contracts
PSYCHIATRIST-PATIENT/CLIENT SERVICES AGREEMENT FRAUKE C. SCHAEFER, MD, INC.Psychiatrist-Patient/Client Services Agreement • January 3rd, 2022
policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law designed to protect your privacy and your 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 we provide you with the attached Notice of Privacy Practices that explains HIPAA and how it affects you. The law also requires that we obtain your signature acknowledging that you have received this information. Although these documents are long and sometimes complex, it is very important that you read them carefully. We can address any questions you have about the procedures before your next session. When you
PSYCHIATRIST-PATIENT/CLIENT SERVICES AGREEMENT FRAUKE C. SCHAEFER, MD, INC.Psychiatrist-Patient/Client Services Agreement • February 17th, 2012
policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law designed to protect your privacy and your 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 we provide you with the attached Notice of Privacy Practices that explains HIPAA and how it affects you. The law also requires that we obtain your signature acknowledging that you have received this information. Although these documents are long and sometimes complex, it is very important that you read them carefully. We can address any questions you have about the procedures before your next session. When you sign this document, it will also represent an agreement between you and your psychiatrist, Frauke C. Schaefer, MD, Inc. You may revoke this Agreement in writing at any time. That revocation will be binding except for information alr
