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Patient Forms
Patient Privacy Notice
The Health Insurance Portability and Accountability Act (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). This notice explains your rights and my responsibilities. You can read the notice here.
Psychologist-Patient Agreement
My policies and procedures are described in this agreement which you can read here.
Patient Signature of Notifications
Before our first appointment please indicate that you have read and understood the Patient Privacy Notice and the Psychologist Patient Agreement by downloading and signing a copy of the Patient Signature form here. Please print and sign the form and bring it with you to the first appointment. |
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