HIPAA Privacy Acknowledgement

Pathways to Better Living Behavioral Health

This form acknowledges that you have received or been offered a copy of the Notice of Privacy Practices for Pathways to Better Living Behavioral Health. The notice explains how your medical and mental health information may be used and disclosed and how you can obtain access to this information.

Your protected health information is maintained and safeguarded in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

Client Information
Acknowledgement
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