Verification of Receipt



Jennifer Daniels PhD, LCPC

Access Counseling Services, Inc.
175 Olde Half Day Road, Suite 140-9, Lincolnshire IL 60069
19 N. County Street Waukegan IL 60085
(224)225-9650 | jennifer@jdanielsphd.com
jdanielsphd.com

 

 

Verification of Receipt

 

NOTICE OF PRIVACY PRACTICES AND CLIENT RIGHTS (HIPAA)

 

I have read and received a copy of the, Notice of Privacy Practices and Client Rights document.  I have also been given the opportunity to ask any questions as to its contents. 

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Signature Certificate
Document name: Verification of Receipt
lock iconUnique Document ID: f8c02146016f6d5d9681cd667d116140e1c23f6e
Timestamp Audit
March 9, 2023 10:33 am CDTVerification of Receipt Uploaded by Jennifer Daniels - jennifer@jdanielsphd.com IP 72.207.59.93