Standard Contracts
Agreement for communication by email with the Tax Counsel Office on disputesEmail Communication Agreement • February 24th, 2020
During adjudication of a dispute, the Tax Counsel Office’s disputes team issues various letters and a detailed final adjudication report to the parties to a dispute. It would be faster and more efficient if the disputes team could communicate with you by email for these purposes.
EMAIL COMMUNICATION AGREEMENTEmail Communication Agreement • April 1st, 2021
Email is becoming the preferred method of communication for many of our parents. Parents often find it difficult to be at school in the mornings and afternoons, email is one strategy we can use to keep our parent community informed and streamline simple communication. Email contact details for all staff will be published on the school website.
UW MEDICINE AGREEMENT FOR EMAIL CORRESPONDENCEEmail Communication Agreement • April 22nd, 2019
Individual Providers and patients may decide to use email to facilitate communication. Some Providers at UW Medicine may communicate via email, but this agreement does not obligate all UW Medicine Providers to communicate via email. Email may be one of many forms of communication with UW Medicine.
EMAIL COMMUNICATION AGREEMENTEmail Communication Agreement • November 6th, 2015
Email is becoming the preferred method of communication for many of our parents. Parents often find it difficult to be at school in the mornings and afternoons, email is one strategy we can use to keep our parent community informed and streamline simple communication. Email contact details for all staff will be published on the school website.
ContractEmail Communication Agreement • July 26th, 2017
+ Crestview + Gulf Breeze + Pensacola 182 E. Redstone 1300 Shoreline Dr. 9050 University Pkwy Ste. A Ste. 104 Pensacola, FL 32514 Crestview, FL 32539 Gulf Breeze, FL 32561
UW MEDICINE AGREEMENT FOR EMAIL CORRESPONDENCEEmail Communication Agreement • July 24th, 2007
Individual Providers and patients may decide to use email to facilitate communication. Some Providers at UW Medicine may communicate via email, but this agreement does not obligate all UW Medicine Providers to communicate via email. Email may be one of many forms of communication with UW Medicine.
John A. Doe, M.D. & Merry Roe, M.D.Email Communication Agreement • June 13th, 2019
UW MEDICINE AGREEMENT FOR EMAIL CORRESPONDENCEEmail Communication Agreement • April 22nd, 2019
Individual Providers and patients may decide to use email to facilitate communication. Some Providers at UW Medicine may communicate via email, but this agreement does not obligate all UW Medicine Providers to communicate via email. Email may be one of many forms of communication with UW Medicine.
DANIEL@DANIELMASLER.COMEmail Communication Agreement • October 16th, 2021
University of Wisconsin Hospitals and Clinics Authority) AGREEMENT FOR EMAIL COMMUNICATION WITH PROTECTED HEALTH INFORMATION – BEHAVIORAL HEALTHEmail Communication Agreement • May 7th, 2021
As a patient in our clinics staff may communicate with you via email if you agree and sign this form. Video group links as well as handouts and references used in group will be sent via email.
Jennifer S. Gale, Psy.D.Email Communication Agreement • September 21st, 2021
UW MEDICINE AGREEMENT FOR EMAIL CORRESPONDENCEEmail Communication Agreement • April 22nd, 2019
Individual Providers and patients may decide to use email to facilitate communication. Some Providers at UW Medicine may communicate via email, but this agreement does not obligate all UW Medicine Providers to communicate via email. Email may be one of many forms of communication with UW Medicine.
Deirdre Stone, Psy.D.Email Communication Agreement • October 4th, 2018
Mendel Psychological AssociatesEmail Communication Agreement • May 25th, 2021
ContractEmail Communication Agreement • May 18th, 2015
Secure electronic messaging is always preferred to insecure email for more sensitive PHI, but under specific circumstances, insecure email communication containing protected health information (PHI) may take place between a mental health provider and a patient. This email communication may be used if both parties agree on this communication method and this form is completed and signed by both the provider and the patient or the patient’s personal representative (if appropriate). A copy of this form and significant email communication will be filed in the patient’s Medical Record and a hard copy of this form will be provided to the patient. This agreement is limited to communications using the email addresses listed below.
Email Communication AgreementEmail Communication Agreement • February 19th, 2013
Gale & Associates Center for Assessment and Psychotherapy PLLCEmail Communication Agreement • March 11th, 2022
