Correctional institution Sample Clauses

Correctional institution. If you are an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your ealth and the health and safety of other individuals. • Law enforcement. We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. • Health oversight agencies and public health authorities. If members of our work force or business associates believe in good faith that we have engaged in unlawful conduct or otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public, they may disclose your health information to health oversight agencies and/or public health authorities, such as the Department of health. • The federal Department of Health and Human Services (“DHHS”). Under the privacy standards, we must disclose your health information to DHHS as necessary to determine our compliance with those standards. I have read, understood and agreed to Neurohealth’s Privacy Policy. SIGNATURE DATE PRINTED NAME INFORMED CONSENT FOR TREATMENT AND NEUROFEEDBACK TRAINING Emerging Technology Treatment Procedures: Neurofeedback (“EEG-biofeedback”) is an increasingly emerging treatment modality that is currently applied to a wide variety of disorders. Neurofeedback for attention deficit/hyperactivity disorder (ADHD), substance addiction, depression, anxiety, and post-traumatic stress disorder (PTSD) have a reasonably good and increasing research basis for clinical application. A full bibliography outlining the research literature on neurofeedback/neurobiofeedback is available on our website (xxx.xxxxxxxxx.xxx). Other psychological, neurological, and behavioral disorders, including tinnitus and tremors, have limited published neurofeedback research available, and neurofeedback treatment of these conditions is currently considered to be “experimental.” Despite the available literature, neurofeedback for these disorders and many others may be considered “investigational” by some insurance providers. By signing this consent form, you acknowledge your understanding that some applications of neurofeedback are still considered to be in the developmental and emerging stages, and you consent to its use in whole or part of your treatment. What is involved with the Neurofeedback Treatment Program? The neurofeedback program requires the completion of one or more of the following assessments: an initial diagnostic inte...
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Correctional institution. If you are or become an inmate of a correctional institution, we may disclose to the institution, or its agents, PHI necessary for your health and the health and safety of other individuals.
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Correctional institution. Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals.
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Correctional institution. Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals. Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public. Notice of Health Information Practices THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
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Correctional institution. If you are an inmate of a correctional institution, we may disclose to the institution or agents thereof, health in- formation necessary to provide you with healthcare; to protect your health and safety or the health and safety of other individuals; or for the safety and security of the correctional institution.
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Correctional institution. If you are or become an inmate of a correctional institution, we may disclose PHI to the institution or its agents when necessary for your health or the health and safety of others. To avert a serious threat to health or safety: We may use and disclose PHI about you when we believe in good faith that disclosure is necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person and the disclosure is to a person reasonably able to prevent the threat. We may disclose your PHI for a medical emergency when we are unable to obtain your consent or authorization due to your condition or the nature of the medical emergency Victims of abuse, neglect, or domestic violence: We may disclose PHI about you to a government authority, such as a social service or protective services agency, if we reasonably believe, in our professional judgment, you are a victim of abuse, neglect, or domestic violence. We will only disclose this type of information (1) to the extent required by law, (2) if you agree to the disclosure, or (3) if the disclosure is allowed by law and we believe it is necessary to prevent serious harm to you or someone else or the law enforcement or public official that is to receive the report represents that it is necessary and will not be used against you.
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Related to Correctional institution

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  • Financial Institution with a Local Client Base A Financial Institution satisfying the following requirements:

  • TELEPHONE & EMERGENCY PROCEDURES If you need to contact Xxxxxxxxx Xxxxx between sessions, please leave a message at the answering service (000-000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hours. If an emergency situation and you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx if any problems arise during the course of therapy regarding your ability to make timely payments. Clients who carry insurance should remember that professional services are rendered and charged to the clients and not to the insurance companies. Unless agreed upon differently, Xxxxxxxxx Xxxxx will provide you with a copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursement, if you so choose. As was indicated in the section, Health Insurance & Confidentiality of Records, you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.

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