Common Contracts
1 similar Outpatient Services Contract contracts
OUTPATIENT SERVICES CONTRACTOutpatient Services Contract • August 12th, 2015
Welcome to our practice. This document contains important information about our professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides new privacy protections and new client 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. Please read this contract carefully and note any questions you might have so that you can discuss them with your therapist. By signing this document, it will represent an agreement between you and Parker Collins. You may revoke this Agreement in writing at any time. That revocation will be binding on me unless we have taken action in reliance on it; eg. if there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or if you have not satisfied any financial obligations
