Common Contracts
1 similar Psychotherapy Agreement contracts
ContractPsychotherapy Agreement • December 14th, 2015
Welcome to The SUMMIT Therapy center. This document (the Agreement) contains important information about our services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA). HIPAA requires that we offer you a Notice of Privacy Practices (the Notice) for use and disclosure of personal health information for treatment, payment and health care operations. The Notice explains HIPAA and its application to your personal health information in greater detail. The law requires that we obtain your signature acknowledging that we have provided you with this information at the end of your first session. We can discuss any questions you may have about the information at that time. When you sign this document, it will also represent an agreement between us. You may revoke this agreement in writing at any time. That revocation will be binding unless we have taken action such as: if there are obligations imposed on us by your h
