OUTPATIENT THERAPY AGREEMENTOutpatient Therapy Agreement • March 29th, 2022
Welcome to our practice. This document contains important information about our professional services and business policies. We have tried to be thorough in discussing different questions and issues, and we have tried to use clear language, instead of legal terms. The Agreement also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a 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 we 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 has been offered to you, explains HIPAA and its application to your personal health information in greater detail. The law requires that we obtain your signature acknowledging that we have provided you wit
OUTPATIENT THERAPY AGREEMENTOutpatient Therapy Agreement • November 16th, 2022
Welcome to our practice. This document contains important information about our professional services and business policies. We’ve tried to be thorough in discussing different questions and issues and have tried to use clear language instead of legal terms. The Agreement also contains 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 we 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 has been offered to you, explains HIPAA and its application to your PHI in greater detail. The law requires that we obtain your signature acknowledging that we have provided you with this information at or before the end of our
