Common Contracts
3 similar Psychologist-Client Services Agreement contracts
PSYCHOLOGIST-CLIENT SERVICES AGREEMENTPsychologist-Client Services Agreement • January 3rd, 2024
Welcome to my practice. This document (the Agreement) contains important information about my professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that covers 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 (the Notice) for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which is provided separately from this Agreement, explains HIPAA and its application to your personal health information in greater detail. The law requires that by the end of our initial session I obtain your signature acknowledging that I have provided you with this information. Although these documents are long and sometimes complex, it is important that
PSYCHOLOGIST-CLIENT SERVICES AGREEMENTPsychologist-Client Services Agreement • May 31st, 2022
Welcome to my practice. This document (the Agreement) contains important information about my professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that covers 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 (the Notice) for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which is provided separately from this Agreement, explains HIPAA and its application to your personal health information in greater detail. The law requires that by the end of our initial session I obtain your signature acknowledging that I have provided you with this information. Although these documents are long and sometimes complex, it is important that
PSYCHOLOGIST-CLIENT SERVICES AGREEMENTPsychologist-Client Services Agreement • November 18th, 2020
Welcome to my practice. This document (the Agreement) contains important information about my professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that covers 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 (the Notice) for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which is provided separately from this Agreement, explains HIPAA and its application to your personal health information in greater detail. The law requires that by the end of our initial session I obtain your signature acknowledging that I have provided you with this information. Although these documents are long and sometimes complex, it is important that
