Forms
(click on the name of the form to access PDF)
WellTherapySF Service Agreement Informed Consent 2023
Informed consent is a document granting me permission from you before conducting a therapy. It outlines procedures about my practice and provides you information on your rights.
WellTherapySF HIPAA 2023
HIPAA is the acronym for the Health Insurance Portability and Accountability Act that was passed by Congress in 1996. HIPAA does the following:
1) Provides the ability to transfer and continue health insurance coverage for millions of American workers and their families when they change or lose their jobs; 2) Reduces health care fraud and abuse; 3) Mandates industry-wide standards for health care information on electronic billing and other processes; and 4) Requires the protection and confidential handling of protected health information.
WellTherapySF Auth Exchange Conf Information 2023 A medical release form is a document that gives me permission to share specific and relevant patient medical information with specific other parties. Under HIPAA regulations, it’s referred to as an “authorization.”