Policies, Consent, and Agreement FormTechnology Assisted Counseling Agreement • December 6th, 2020
Contract Type FiledDecember 6th, 2020This form is in addition to the regular Therapy, Policies, Agreement and Consent Form and Notice of Privacy Practices for Protected Health Information commonly known as HIPAA. You must sign both in order to participate in Technology Assisted Counseling (TAC) sessions. TAC incorporates email, phone and video counseling. Prior to engage in TAC an assessment/consultation will be done to assure that TAC is an appropriate form of counseling. This is to inform you about what you can expect regarding your participation in TAC counseling.
ELECTRONIC COMMUNICATION ACKNOWLEDGEMENT TECHNOLOGY ASSISTED COUNSELING AGREEMENT AND CONSENTTechnology Assisted Counseling Agreement • September 18th, 2017
Contract Type FiledSeptember 18th, 2017
TECHNOLOGY ASSISTED COUNSELING AGREEMENT AND CONSENTTechnology Assisted Counseling Agreement • July 16th, 2015
Contract Type FiledJuly 16th, 2015