Common Contracts

2 similar null contracts

OUTPATIENT THERAPY AGREEMENT
March 29th, 2022
  • Filed
    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

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OUTPATIENT THERAPY AGREEMENT
March 31st, 2020
  • Filed
    March 31st, 2020

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

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