Common Contracts
1 similar Psychologist-Client Services Agreement contracts
PSYCHOLOGIST-CLIENT SERVICES AGREEMENTPsychologist-Client Services Agreement • December 30th, 2021
Welcome, 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 new federal law that provides new privacy protections and new 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 accompanies this Agreement, explains HIPAA and its application to your personal health information in greater detail. The law requires that I obtain your signature acknowledging that I have provided you with this information at the end of your initial intake session (or first session subsequent to the implementation date of April 14, 2003). Although the
