CSimpleWorks, PLLC - Family System Therapy
HIPAA Forms Required for Consumers
Available and reviewed during first scheduled session.
Revised: Personal Disclosure, Consent for Treatment, Notice of Privacy Practices, and Financial Agreement  Effective July 2017
WA state enforces HIPAA and HITECH standards effective
September 23, 2013.  Consumers may contact:
WA Department of Health (WA DOH)
Health Professions Quality Assurance
Counselor Section
PO Box 47869
Olympia, WA 98504
HIPAA and HITECH new standards effective September 23, 2013: 
  • HIPAA (Health Information Portability & Accountability Act)
  • HITECH (Health Information Technology for Economic & Clinical Health)

There are many changes that impact healthcare providers to protect consumers.  Included among these are:
  • notifying you of these requirements,
  • encryption of files and electronic communications (HITECH),
  • notifications like Notice of Privacy Practices, to name a few. 
You will receive all forms directly from me that are required during your first session which includes an additional 30 minutes to review  documents, clarify questions and concerns, determine your next session appointment, and produce payment for existing session based on your Fee Agreement
Terms of your Fee Agreement, Consent for Treatment, and my Disclosure Statement remain required documents you must receive before services can begin, and are reviewed in first session.