Superbill Template

Customizable, Attorney Approved Private Practice Paperwork

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PRIVATE PRACTICE PAPERWORK DISCLAIMER AND
WAIVER OF LIABILITY
These forms are provided as example formats to be used in a therapy private practice. They do not set, nor do they purport to set the standard in documentation of care for therapists. While the forms are drafted with legal compliance in mind, they do not purport to replace the advice of compliance professionals, nor supplant the individual therapist’s obligations to comply with legal, clinical and ethical requirements. Each therapist is responsible to use his or her professional judgment and assumes all responsibility for clinical treatment and documentation for individual patients.
By using these forms, you agree to release K2 Visionaries, LLC dba The Private Practice Startup dba The Private Practice Startup from all liability relating to injuries that may occur with use of these forms and to indemnify K2 Visionaries, LLC dba The Private Practice Startup dba The Private Practice Startup from any third party claims resulting from the use of these forms. By using these forms, I agree to hold K2 Visionaries, LLC dba The Private Practice Startup dba The Private Practice Startup entirely free from any liability, including financial responsibility for injuries incurred, regardless of whether injuries are alleged to have been caused by negligence in preparation of the forms.
By purchasing these forms you also agree not to give, resell, publish, or give another person permission to resell, publish, or use these documents in their practice.
It is the therapist’s responsibility to keep up to date with any changes in the laws and ethics that govern his or her specific profession and adjust his or her documentation accordingly. Since these documents are working documents and at times you may need to change, add or revise, you agree NOT to remove the copyright at the bottom of each page of the document.
Laws regulating the practice of psychotherapy can vary from state to state and you are responsible for being aware of, and complying with, the laws and rules applicable to your practice, including the laws relating to consent, privacy and intra-jurisdictional practice in connection with remote therapy sessions. By using these forms, you are acknowledging your responsibility to practice in compliance with the law independently of the forms themselves.
K2 Visionaries, LLC dba The Private Practice Startup dba The Private Practice Startup understands that each therapist will use these documents in a way that suits their practice and client needs. You agree not to post these documents on your website, social media or anywhere the public can copy and paste them for their own use. If you wish to post to your website the page should remain hidden to the public, but can be accessed by a link you send specifically to your clients.
It is the therapist’s responsibility to read through EVERY aspect of these forms prior to use. Do NOT use the forms without reading them thoroughly and updating them regarding your specific practice. The therapist needs to assure he or she updates their name, credentials, company name, prices, policies, etc.
These documents are copyrighted by K2 Visionaries, LLC dba The Private Practice Startup and are licensed to the purchaser for individual use only and the context of his or her practice and use with clients.
These documents may not be sold, distributed or licensed by the purchaser for use by another individual or entity and any distribution, outside of the practice of the purchaser is strictly prohibited. By using these forms under the license implied by the purchase, purchaser agrees that it cannot sell, transfer, assign or otherwise distribute these documents.
There are no returns on the paperwork. The paperwork is a digital product and can not be returned once received.
The paperwork is delivered in Word format. You need to have Word on your computer or another compatible program to use these documents. Refunds will not be given in the case that someone who purchases the product does not have Word or another compatible program.
From time to time K2 Visionaries, LLC dba The Private Practice Startup will hold sales and promotions. If you have purchased paperwork within 7 days of a sales or promotion that is less than what you paid for it initially you can contact K2 Visionaries, LLC dba The Private Practice Startup, and they will refund you the difference.
I have read and understand the information contained in the Disclaimer and Waiver of Liability. I have discussed any questions that I have regarding this information. I understand that all sales are final. My purchase indicates that I agree to abide by the disclaimer and waiver of liability as outlined above.
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