© 2016 by North Star Therapy, PLLC. (updated March 2019)

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Text/Email Informed Consent

This form provides the guidelines for using text and email to communicate with Dr. Khanzadeh and North Star Therapy, PLLC.

HIPPA/ client rights

This document provides you with the details of HIPAA PRIVACY RULE, outlining your rights, confidentiality and how to file a complaint with HSS.

Financial agreement

This document provides an explanation of your financial responsibilities.  You are highly encouraged to contact your insurance company directly to determine what your financial responsibilities entails.    

Release of information

The release of information is for you to sign, if you like for me to consult or converse with a third party.

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