Common Contracts

1 similar Assessment-Patient Services Agreement contracts

ASSESSMENT-PATIENT SERVICES AGREEMENT
Assessment-Patient Services Agreement • September 16th, 2017

Welcome to Hawaii Center for Psychology (HCP). This document (the Agreement) contains important information about our professional services and business policies. It also contains summary 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 HCP provide you with a Notice of Privacy Practices (the Notice) for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which is attached to this Agreement, explains HIPAA and its application to your personal health information in greater detail. The law requires that HCP obtain your signature acknowledging that this information has been provided to you at the end of this session. Although these documents are long and sometimes complex, it is very

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