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- Agreement of Therapy Services
- Once you and Dr. Chambliss have decided to work with each other, please review and sign this Agreement.
This Agreement reflects policies regarding fees and other administrative issues related to professional services.
Please bring the signed Agreement to your next appointment.
- Agreement of Therapy Services (PDF)*
- Notice of Privacy Practices (HIPAA)
- In addition, please review this Notice of Privacy Practices. Sign the first page, and bring the signed first page
to your next appointment.
HIPPA Notice of Privacy Practices (PDF)*
- * NOTE:
- Documents are in PDF. PDF requires that you have a copy of Adobe Acrobat Reader installed on your computer. You
can download a free copy from: http://www.adobe.com/.
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