Common Contracts
1 similar Informed Consent and Service Agreement contracts
INFORMED CONSENT AND SERVICE AGREEMENTInformed Consent and Service Agreement • March 21st, 2008
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 new federal law that provides new privacy protections and new patient rights with regard to the use and disclosure of your Protected Health Information used for the purpose of treatment, payment, and health care operations. HIPAA requires that I provide you with a Notice of Privacy Practices for use and disclosure of PHI for treatment, payment and health care operations. The Notice explains HIPAA and its application to your personal health information in greater detail. The law requires that I obtain your signature acknowledging that I have provided you with this information at the end of the first session if possible. Although these documents are long and sometimes complex, it is very important that you read them carefully before our next session. I can discuss any questions you
