HIPAA Privacy Acknowledgement

Divine Healing Behavioral Health

This form acknowledges that you have received or been offered a copy of the Notice of Privacy Practices for Divine Healing 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).

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Acknowledgement
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