HIPPA - Notice of Privacy Practices

Currently, Psychiatric Empowerment Service, PLLC’s HIPPA notification is available through our website. We ask that you provide an attestation and acknowledgement of receipt and understanding of HIPPA privacy regulations.

Please read and understand the HIPPA - Notice of Privacy Practices before acknowledging receipt and understanding.

Psychiatric Empowerment Services, PLLC

HIPPA - Notice of Privacy Practices

By selecting "YES" and entering in my name and date and clicking the "submit" button below I am acknowledging the contents and provisions of the HIPPA - Notice of Privacy Practices for Psychiatric Empowerment Services, PLLC.

Fields marked with an asterisk (*) are required.

Acknowledgement

YES - I acknowledge I have read and understand the HIPPA - Notice of Privacy Practices for Psychiatric Empowerment Services, PLLC.

Your legal name

First Name

Last Name

Today's Date

YYYY