CLIENT CONSENT AND AGREEMENT FOR PSYCHOLOGICAL SERVICESClient Consent and Agreement for Psychological Services • June 28th, 2022
This document (the Agreement) contains important information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and client 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 Julie Keen, LLC, provide you with a Notice of Privacy Practices (the Notice). The Notice explains HIPAA and its application to your personal health information in greater detail.
