Common Contracts

1 similar Counselor-Client Services Agreement contracts

Counselor-Client Services Agreement and Notice of Privacy Practices
Counselor-Client Services Agreement • September 17th, 2020

Welcome to my counseling 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). HIPAA is a Federal law that provides privacy protection and 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 I provide you with a Notice of Privacy Practices (the Notice). The Notice, which is incorporated here, explains HIPAA and its application to your personal health information. The law requires me to obtain your signature acknowledging that I have provided you with this information. Although this document is long, please read it carefully. We can discuss any questions you have about its content. When you sign the Acknowledgement of Notice of Privacy Practice and Service Agreement, it will represent an agreement