AGREEMENT FOR PSYCHOLOGICAL SERVICESAgreement for Psychological Services • August 5th, 2010
This Agreement made this day of , 20 , by and between Clinical Associates, P.A., located at 8629 Bluejacket Street, Suite 100, Lenexa, Kansas, hereinafter referred to as "Clinical Associates," and the City of Overland Park, Kansas, a municipal corporation, hereinafter referred to as "City," the City of Overland Park being a City in the first class, located at 8500 Santa Fe, Overland Park, Kansas 66212.
AGREEMENT FOR PSYCHOLOGICAL SERVICESAgreement for Psychological Services • July 2nd, 2019
Formerly known as Grace Blocher, Ph.D & Associates, LLC., since 2015, our practice underwent a name change in June of 2018 to Graceway Psychology Group, LLC. We are operating under both names during the transition period until the former name is dissolved.
AGREEMENT FOR PSYCHOLOGICAL SERVICESAgreement for Psychological Services • May 2nd, 2012
This Agreement made this day of May 2012 by and between Clinical Associates, P.A., located at 8629 Bluejacket Street, Suite 100, Lenexa, Kansas, hereinafter referred to as "Clinical Associates," and the City of Overland Park, Kansas, a municipal corporation, hereinafter referred to as "City," the City of Overland Park being a City in the first class, located at 8500 Santa Fe, Overland Park, Kansas 66212.
Psychological Sunrise Center, PLLC Dr. Dina Reimer, Psy.D.Agreement for Psychological Services • October 1st, 2013
This 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 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 I provide you with a Notice of Privacy Practices for use and disclosure of PHI for treatment, payment and health care operations. The Notice, given with 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. Although these documents are long and sometimes complex, it is very important that you read them carefully before our next session. We can discuss any questions you have about the proce
