Common Contracts
1 similar null contracts
Krysta Pilar Meany, Psy.D. Licensed Clinical Psychologist, PSY27556October 8th, 2019
This form provides you, the patient, with important information about professional services and business practices. It also contains information about the Health Insurance Portability Act (HIPPA), as part of federal law, which provides information about Protected Health Information (PHI). As required by federal law, attached is The Notice of Privacy Practice for use and disclosure of PHI treatment, payment and health care operations. The law requires that you provide a signature verifying that you were supplied with this agreement. You may revoke this agreement at any time in writing.
