Forms

In response to the Health Insurance Portability and Accountability Act (HIPAA) of 1996, Public Law 104-191, the United States Department of Health and Human Services published a regulation in the form of the Privacy Rule. The resulting requirements include:

  • A covered health care provider with a direct treatment relationship with individuals must deliver a privacy practices notice to patients
  • A covered health care provider with a direct treatment relationship with individuals must make a good faith effort to obtain written acknowledgement from patients of receipt of the privacy practices notice
For the fulfillment of these requirements, please print and read the Notice of Privacy Practices.  Also, please print and sign the Consent Form and present it to Dr. Maurer at your first scheduled therapy session.



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Notice of Privacy Practices
Consent Form

 
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