THERAPIST-CLIENT SERVICE AGREEMENTTherapist-Client Service Agreement • September 22nd, 2021
Contract Type FiledSeptember 22nd, 2021Welcome to my practice. This document 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 about the use and disclosure of your Protected Health Information (PHI) for the purposes of treatment, payment, and health care operations. Although these documents are long and sometimes complex, it is very important that you understand them. When you sign this document, it will also represent an agreement between us. We can discuss any questions you have when you sign them or at any time in the future.
THERAPIST - CLIENT SERVICE AGREEMENTTherapist - Client Service Agreement • July 1st, 2024
Contract Type FiledJuly 1st, 2024Welcome to my practice. This document 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 about the use and disclosure of your Protected Health Information (PHI) for the purposes of treatment, payment, and health care operations. When you sign this document, it represents an agreement between us. We can discuss any questions you have when you sign them or at any time in the future.
THERAPIST - CLIENT SERVICE AGREEMENTTherapist - Client Service Agreement • August 27th, 2022
Contract Type FiledAugust 27th, 2022Welcome to my practice. This document 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 about the use and disclosure of your Protected Health Information (PHI) for the purposes of treatment, payment, and health care operations. When you sign this document, it represents an agreement between us. We can discuss any questions you have when you sign them or at any time in the future.
THERAPIST-CLIENT SERVICE AGREEMENTTherapist-Client Service Agreement • September 2nd, 2020
Contract Type FiledSeptember 2nd, 2020Welcome to New Hope Behavioral Health, LLC. This document 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 about the use and disclosure of your Protected Health Information (PHI) for the purposes of treatment, payment, and health care operations.
THERAPIST-CLIENT SERVICE AGREEMENT-INFORMED CONSENTTherapist-Client Service Agreement • January 29th, 2020
Contract Type FiledJanuary 29th, 2020The following is a description of your rights and responsibilities. Please read carefully before signing your consent to meet with a therapist.