Patient Medical Records and Clinical Notes
You agree to sign a HIPAA agreement to release medical records pertaining to the patient’s care, permit a physician order for care and to not tamper, alter or prevent VIPrivate Care from its clinical records.
Clinical notes/records must be stored and kept from any person other than the contracted caregivers themselves or its management.
We require immediate return of all Clinical Notes/records for legal purposes.
HIPAA, Patient and Home Care Rights
Please see the NYS Patient Handbook
The Agreement shall be governed by, construed in accordance with, The Laws of the State of New York notwithstanding any conflict-of-laws doctrine to the contrary. This agreement may be executed and delivered by fax to 646-219-4593 and/or scanned and emailed to firstname.lastname@example.org or mailed to 10 Herrick Drive Old Tappan, NJ 07675 and will be binding whether executed manual in the original or by other means and may be legally executed by a DPOA, POA or Spouse or legal party related to the patient.
This agreement represents legal Home Care and Concierge Nursing services to the party.
In terms set forth in any Agreement are satisfactory, please sign and date a copy of the agreement and return by the means sated above.
Should you have any questions or changes to this agreement, please call 866.863.6800 and speak to Patient Services to avoid any misunderstanding or misinterpretation concerning this engagement.