Common Contracts
1 similar Therapist-Client Services Agreement contracts
THERAPIST-CLIENT SERVICES AGREEMENTTherapist-Client Services Agreement • February 11th, 2020
Welcome. This document contains important information about our practice and its business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law designed to protect your privacy and your 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 we provide you with the attached Notice of Privacy Practices that explains HIPAA and how it affects you. The law also requires that we obtain your signature acknowledging that you have received this information. Although these documents are long and sometimes complex, it is very important that you read them carefully. I can address any questions you have about the procedures before your next session. When you sign this document, it will also represent an agreement between you and Diane T. Jacob, MA, MA, LPCA, your therapist. You may revoke this Agree
