HIPAA & Terms of Service
Your Rights under HIPAA
Notice of Privacy Practices Revised Effective Date 11/08/05
This notice provides information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and patient right with regard to the use and disclosure of your Protected health Information (PHI). In this Notice, we will call all of that protected health information “medical information.” THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. We will be happy to answer any of your questions.
HIPAA requires that we provide you with a copy of this Notice, and that we attempt to obtain your signature acknowledging receipt of this Notice.
How We May Use and Disclose Medical Information About You
We use and disclose medical information about you for a number of different purposes. Each of those purposes is described below.
For Treatment
We may use medical information about you to provide, coordinate or manage your health care and related services by both us and other health care providers. We may disclose medical information about you to doctors, nurses, hospitals and other health facilities who become involved in your care with your consent. We may consult with other health care providers within this practice concerning you and as part of the consultation share your medical information with them. We may refer you to another health care provider and as part of the referral, may share medical information about you with that provider with your consent. For example, we may conclude you need to receive services from a physician or therapist with a particular specialty. When we refer you to that physician or therapist, we also will contact that physician or therapist’s office and provide medical information about you to them so they have information they need to provide services for you.
For Payment (for in-person services only)
We may use and disclose medical information about you so we can be paid for the services we provide to you with your consent. This can include billing to you, your insurance company, or a third party payer. For example, we may need to give your insurance company information about the health care services we provide to you so your insurance company will pay us for those services or reimburse you for amounts you have paid. We also may need to provide your insurance company or a government program, such as Medicare or Medicaid, with information about your medical condition and the health care you need to receive to obtain a determination if you are covered by that insurance or program.
For Health Care Operations
We may use and disclose medical information about you for our own health care operations. These are necessary for us to operate FORENSICDUI and to maintain quality health care for our patients. For example, we may use medical information about you to review the services we provide and performance of our staff in caring for you. We may also use the information to study ways to more efficiently manage our organization, or we may need to share your information with people or companies who perform services for us, such as our lawyer or accountant, on an as needed basis.
How We Will Contact You
Unless you tell us otherwise in writing, we may contact you by either telephone or by mail at either your home or your workplace. At either location, we may leave messages for you on the answering machine or voice mail. If you want to request that we communicate to you in a certain way or at a certain location, see “Right to Receive Confidential Communications.”
Appointment Reminders
We may use and disclose medical information about you to contact you to remind you of an appointment you have with us.
Treatment Alternatives
We may use and disclose medical information about you to contact you about treatment alternatives that may be of interest to you.
Required or Allowed By Law
We may use or disclose medical information about you when we are required or allowed to do so by law.
Public Health Activities
We may disclose medical information about you for public health activities and purposes. This includes reporting medical information to a public health authority that is authorized by law to collect or receive the information for purposes of preventing or controlling disease. Or, one that is authorized to receive reports of child abuse and neglect.
Victims of Abuse or Neglect/Duty to Protect
We may disclose medical information to a government authority authorized by law to receive reports of abuse or neglect, or to other specified individuals/agencies, if we believe you are or another person is a victim or potential victim of abuse or neglect. This may involve a child under 18, a mentally retarded/developmentally disabled individual, or a senior adult. This will occur to the extent the disclosure is: (a) required by law; (b) agreed to by you; or (c) authorized by law and we believe the disclosure is necessary to prevent serious harm to you or to other potential victims.
Health Oversight Activities
We may disclose medical information about you to a health oversight agency for activities authorized by law, including audits, investigations, inspections, licensure or disciplinary actions. These and similar types of activities are necessary for appropriate oversight of the health care system, government benefit programs, and entities subject to various government regulations.
Judicial and Administrative Proceedings
We may disclose medical information about you in the course of any judicial or administrative proceeding in response to an order of the court or administrative tribunal.
Disclosures for Law Enforcement Purposes
We may disclose medical information about you to a law enforcement official for law enforcement purposes:
1. As required by law.
2. In response to a court, grand jury or administrative order, warrant or subpoena
3. To identify or locate a suspect, fugitive, material witness or missing person.
4. About an actual or suspected victim of a crime and that person agrees to the disclosure. If we are unable to obtain that person’s agreement, in limited circumstances, the information may still be disclosed.
5. About an actual or suspected victim of a crime and that person agrees to the disclosure. If we are unable to obtain that person’s agreement, in limited circumstances, the information may still be disclosed.
6. To alert law enforcement officials to a death if we suspect the death may have resulted from criminal conduct.
7. About crimes that occur at our facility.
8. To report a crime in emergency circumstances.
Workers’ Compensation
We may disclose medical information about you to the extent necessary to comply with workers’ compensation and similar laws that provide benefits for work-related injuries or illness without regard to fault.
Mental Health or Chemical Dependency Records
If we receive health information about you from a health care provider, we will not re-disclose or otherwise reveal any mental health or chemical dependency records contained in that information, beyond the purpose of the disclosure to us, without first obtaining your written authorization, if that is required by law. There are certain other times when we may disclose information, including if you are a member of the armed forces, in certain instances involving National Security and Intelligence, or if you are an inmate.
Other Uses and Disclosures
Other uses and disclosures will be made only with your written authorization. You may revoke such an authorization at any time by notifying your therapist in writing of your desire to revoke it. However, if you revoke such an authorization, it will not have any effect on actions taken by us in reliance on it.
Your Rights With Respect to Medical Information About You
You have the following rights with respect to medical information that we maintain about you.
Right to Request Restrictions
You have the right to request that we restrict the uses or disclosures of medical information about you to carry out treatment, payment, or health care operations.
To request a restriction, you may do so at any time. If you request a restriction, you should do so with your therapist and tell us: (a) what information you want to limit; (b) whether you want to limit use or disclosure or both; and , (c) to whom you want the limits to apply.
We are not required to agree to any requested restriction. However, if we do agree, we will follow that restriction unless the information is needed to provide emergency treatment. Even if we agree to a restriction, either you or we can later terminate the restriction.
Right to Receive Confidential Communications
You have the right to request that we communicate medical information about you to you in a certain way or at a certain location. For example, you can ask that we only contact you by mail, email or at work. We will not require you to tell us why you are asking for the confidential communication.
If you want to request confidential communication, you must do so in writing to your therapist. Your request must state how or where you can be contacted.
We will accommodate your request. However, we may, when appropriate, require information from you concerning how payment will be handled. We also may require an alternate address or other method to contact you.
Right to Inspect and Copy
With a few very limited exceptions, you have the right to inspect and obtain a copy of medical information about you. You have an absolute right to all materials created by your treating therapist.
To inspect or copy medical information about you, you must submit your request in writing to your therapist. Your request should state specifically what medical information you want to inspect or copy. If you request a copy of the information, we may charge a fee for the costs of copying and, if you ask that it be mailed to you, the cost of mailing. You may be required to sign two authorization forms, one for psychotherapy notes and one for the rest of the records.
We will act on your request within thirty (30) calendar days after we receive your request. If we grant your request, in whole or in part, we will inform you of our acceptance of your request and provide access and copies.
We may deny your request to inspect and copy medical information if the medical information involved is information compiled in anticipation of, or use in , a civil, criminal or administrative action or proceeding, i.e. that the information was not created for treatment purposes.
If we deny your request, we will inform you of the basis for the denial, how you may have our denial reviewed, and how you may complain. If you request a review of our denial, it will be conducted by a licensed health care professional designated by us who was not directly involved in the denial. We will comply with the outcome of that review.
Right to Amend
You have the right to ask us to amend medical information about you. You have this right for so long as the medical information is maintained by us.
To request an amendment, you must submit your request in writing to your therapist. Your request must state the amendment desired and provide a reason in support of that amendment.
We will act on your request within sixty (60) calendar days after we receive your request. If we grant your request, in whole or in part, we will inform you of our acceptance of your request and provide access and copying.
If we grant the request, in whole or in part, we will seek your identification of and agreement to share the amendment with relevant other persons. We also will make the appropriate amendment to the medical information by appending or otherwise providing a link to the amendment.
We may deny your request to amend medical information about you. We may deny your request if it is not in writing and does not provide a reason in support of the amendment. In addition, we may deny your request to amend medical information if we determine the information:
1. was not created by us, unless the person or entity that created the information is no longer available to act on the requested amendment;
2. is not a part of the medical information maintained by us;
3. would not be available for you to inspect or copy; OR
4. is not accurate and complete.
If you do not submit a statement of disagreement, you may ask that we include your request for amendment and our denial with any future disclosures of the information. We will include your request for amendment and our denial (or summary of that information) with any subsequent disclosure of the medical information involved.
You also will have the right to complain about our denial of your request.
Right to an Accounting of Disclosures
You have the right to receive an accounting of disclosures of medical information about you. The accounting may be for up to six (6) years prior to the date on which you request the accounting but not before April 14, 2003.
Certain types of disclosures are not included in such an accounting, including:
1. Disclosures to carry out treatment, payment and health care options.
2. Disclosures of your medical information made to you.
3. Disclosures that are incident to another use or disclosure
4. Disclosures that you have authorized.
Under certain circumstances your right to an accounting of disclosures to a law enforcement official or health oversight agency may be suspended. Should you request an accounting during the period of time your right is suspended, the accounting would not include the disclosure or disclosures to a law enforcement official or to a health oversight agency.
To request an accounting of disclosures you must submit your request in writing to your therapist. Your request must state a time period for the disclosures. It may not be longer that six (6) years from the date we receive your request and may not include dates before April 14, 2003.
Usually, we will act on your request within sixty (60) calendar days after we receive your request. Within that time, we will either provide the accounting of disclosures to you or give you a written statement of when we will provide the accounting and why the delay is necessary.
There is no charge for the first accounting we provide to you in any twelve (12) month period. For additional accountings, we may charge you for the cost of providing the list. If there will be a charge, we will notify you of the cost involved and give you an opportunity to withdraw or modify your request to avoid or reduce the fee.
Right to Copy of This Notice
You have the right to obtain a paper copy of our Notice of Privacy Practices, upon request, even if you agreed to receive the notice electronically. You may request a copy of our Notice of Privacy Practices at any time. To obtain a paper copy of this notice, contact your therapist.
Our Duties
Generally
We are required by law to maintain the privacy of medical information about you and to provide the individuals with notice or our legal duties and privacy practices with respect to medical information.
We are required to abide by the terms of our Notice of Privacy Practices in effect at the time.
Our Right to Change Notice of Privacy Practices
We reserve the right to change this Notice of Privacy Practices. We reserve the right to make the new notice’s provisions effective for all medical information that we maintain, including that created or received by us prior to the effective date of the new notice. We will provide you with a revised notice by mail or fax upon request.
Availability of Notice of Privacy Practices
At any time, you may obtain a paper copy of our current Notice of Privacy Practices.
Effective Date of Notice
The effective date of the notice will be stated on the first page of the notice.
Complaints
You may complain to us and/or to the United States Secretary of Health and Human Services if you believe that we have violated your privacy rights.
To file a complaint with us, contact the Director of the practice at:
FORENSIC DUI.com
PO Box 13852
Alexandria LA 71315
To file a complaint with the United States Secretary of Health and Human Services, write, call, or fax your complaint to:
Region V, Office for Civil Rights
U.S. Department of Health and Human Services
You will not be retaliated against for filing a complaint.
Questions and Information
If you have any questions or want more information concerning this Notice of Privacy Practices, please contact your therapist or the Executive Director of FORENSIC FUI at 318-451-4282.
Terms of Service
Consent for Service, Limits and Terms of Use Agreement
Anyone registering, paying, and choosing to use FORENSIC DUI agrees to the following Consent for Service, Limits and Terms of Use:
Company Name / Client Reference Hereafter
FORENSIC DUI is a division of Harvey Norris, INC Incorporated, a corporation established in the state of Louisiana. The term "FORENSIC DUI" refers to the corporate entity, as well as its website (ndsbs.com), directors, officers, agents, employees, successors and assigns. Hereafter, registered users of the FORENSIC DUI.com website shall be referred to as "you/your", "client" or "the client".
Adults/Minors Requesting Service
You agree that you are 18 years old or older, and if you are not, you will have a parent or guardian establish the registration, payment and Consent for Service and Terms of Use Agreement on your behalf. However, minors using our service to obtain an assessment, agree to complete the online questionnaire portion of the assessment without the assistance of parent, guardian or any other third parties.
Solo Participation & False Identity
You agree to answer questions and questionnaires without the presence or assistance of any third party and agree not to have any third party present at an in-person, telephone or video/webcam interview without first making a direct request to FORENSIC DUI.com and stating the reason that you wish for a third party to be present. FORENSIC DUI.com has the right to deny any such requests if they deem them inappropriate for any reason. You explicitly agree to not have another party stand in as your representative or falsely present themselves in an interview using your identity.
Online Service Limitations
FORENSIC DUI.com provides in-person as well as online services. You understand that use of online services may not be an appropriate form of care for persons in an emotional or mental health crisis. We reserve the right to assess your situation and decline to offer you services if we believe it is not in your best interests to do so. If we are working with you and a mental health crisis develops we will refer you to your local emergency services and mental health providers where you can be seen in-person. Any fees paid to FORENSIC DUI.com prior to a mental health crisis will qualify for consideration of a partial or full refund, at the discretion of the FORENSIC DUI.com Director, and depending on the amount of services rendered before a referral to a local agency is made.
Consent for Treatment
You understand and consent to treatment for professional services from FORENSIC DUI.com. FORENSIC DUI.com services are provided by certified and/or licensed mental health practitioners and as such may render a mental health diagnosis where appropriate and indicate such diagnoses in your written records. You also consent to the release of information for therapeutic, billing, supervision and other purposes in connection with your treatment, between and among FORENSIC DUI.com therapists, staff and service contractors who perform supervisory work on behalf of FORENSIC DUI.com. You understand that for a more detailed description of how your (or your child’s) health information may be released and used is contained in the current Notice of Privacy Practices. This is available on the ndsbs.com website.
General Information Security Practices
FORENSIC DUI.com recognizes the absolute importance of keeping client records private and confidential. This section of the Agreement includes our general security practices to keep your information private:
all records are stored on SSL encrypted servers
paper records/documents related to your service are kept in locked cabinets
account passwords are set to health industry standards to include appropriate length and sufficient variation in characters to minimize chances of access by any third party
sessions conducted via webcam/video are not recorded by FORENSIC DUI.com.
FORENSIC DUI.com does not sell your email or other personal contact information to any parties
Occasionally for training and supervision purposes we may request that you allow an audio recording of your clinical interview. You are free to decline such requests and any recordings agreed to will be destroyed within 30 days of the recording
Limits to Confidentiality and Privacy
Privacy and confidentiality are not only important to have a trusted exchange of client/ clinician information, but they are also items subject to federal law. NDSBS complies with federal confidentiality guidelines under Federal Confidentiality regulations (42 CFR Part 2) and the Health Insurance Portability and Accountability Act (HIPAA 45 CFR). This protection of confidentiality also specifically (42/Part 2) protects the records of mental health, alcohol and drug abuse patients, including the prohibition of re-disclosure of information from client/patient records. HIPAA also requires that mental health and substance abuse professionals provide notice to all clients that information provided by FORENSIC DUI.com and voluntarily disclosed to third parties by you (to courts, probation officers, physicians, schools, etc.) may be re-disclosed by these third parties.
Furthermore, in compliance with the aforementioned federal laws, FORENSIC DUI.com has the obligation to limit client/customer confidentiality and report specific information in the following circumstances:
FORENSIC DUI.com is mandated to report suspected or known abuse of children and vulnerable adults to local law enforcement and/or local child/adult protective agencies.
FORENSIC DUI.com is mandated to report specific information to local law enforcement in situations where a client is at significant risk for taking their own life or the life (or lives) of another (others). FORENSIC DUI.com will make a concerted effort to assist clients in accessing appropriate professional care in such circumstances.
FORENSIC DUI.com is obligated to release your records for legal proceedings if ordered by a court to do so.
FORENSIC DUI.com uses security encrypted (SSL) transmission for all professional assessment and counseling services completed online. If you choose a webcam/video/telephone service, including uploading, downloading, or faxing personal information to or from FORENSIC DUI.com, you should be aware that risk of interception of your information, though unlikely, is a possibility. FORENSIC DUI.com client records are stored on encrypted secure servers or in secure facilities where access is limited to the professional evaluator assigned to the client and their clinical supervisors. Identifying names are not used by the evaluator if discussing client circumstances with a professional supervisor.
There is also no express or implied warranty for any client losses, damage or harm occurring from the use of electronic services, which would include: unauthorized data interception or data/records theft by a third party, unintended utility charges by a third party, computer/electronic viruses, accidental deletion of data or records, or any other claim of harm arising from your choice to engage FORENSIC DUI.com services using electronic means (telephone, fax, internet, wireless, email, video/webcam or any other electronic delivery services that might be used in the future).
Responsibility for Transfer of Your Records to Requesting Parties
You understand that FORENSIC DUI.com will place an official document or report signed by a credentialed professional in your online account with FORENSIC DUI.com. As noted elsewhere in this document you are responsible to review the document in its entirety before releasing it to any person or company. You may provide the official document to any requesting party at any time (e.g. court, probation officer, attorney, employer, etc.)
Delivery Timeframes
Standard report deliveries are within 5 business days of the time of your clinical interview. The report will be delivered to your account by the end of the appropriate business day (5pm) in your time zone. Your account with us will include a time stamp showing the date and time your report is posted.
Rush Order time frames are defined as follows:
Same business day delivery – by 5pm in your time zone on the day of your clinical interview. If ordering an assessment near the end of the business day you may be required to pay a same-day rush order fee in order to have the report ready by a morning deadline of 8am or 9am.
Next business day delivery – by 5pm in your time zone on the next business day after your clinical interview
Two to three business day delivery – by 5pm in your time zone on the third business day after your clinical interview
Saturday, Sunday, evenings and holidays are not considered business days and services rendered during such times may be quoted with additional convenience fees determined at the time you contact us for an assessment.
Note: if you need your rushed report earlier than 5pm on the due date please let us know by phone and document this agreement for your records by email exchange with our administrative staff or your evaluator.
Financial Responsibility & Fees
You understand that payment for service is due before receiving services from FORENSIC DUI.com. Additionally, you understand that FORENSIC DUI.com has no contractual obligation with your insurance company or yourself that would guarantee reimbursement for expenses you incur for any and all services provided by FORENSIC DUI.com.
You also understand that fees for services are posted on our website except in certain cases where fees are dependent on time demands of your case (e.g. in depth assessments for child custody, FAA assessments, ILC evaluations, some license reinstatement assessments, or other services which are determined and mutually agreed upon at the time of the service request).
Drug Testing Terms
You understand that substance use or drug and/or alcohol evaluations may include chemical tests on a case-by-case basis. In the event you are not present in our office at the time of your assessment, you may be asked to obtain an independent chemical test (e.g. urine drug screen, hair test sample, etc.) from a professional lab to present with your final assessment report. Chemical test fees are not included in the cost of your FORENSIC DUI.com assessment and are the sole responsibility of the client.
Client Cancellation Policy and Broken Appointment Fees
You understand and agree that a fee will be charged to your account if you cancel your interview or appointment with less than 24 hours’ notice. You also understand and agree that FORENSIC DUI.com reserves the right to cancel your service and refund your payments minus any broken appointment fees if you cancel 2 or more scheduled interview or appointment times with less than 24 hours’ notice. Broken appointment fees are $50.00 per appointment and are charged to partially offset the loss of revenue which occurs when a time has been reserved for a client but which can no longer be booked due to the short notice in cancellation.
Client Will Accurately Report Information
As a client, you agree to provide accurate information about yourself and the circumstances surrounding your need for an evaluation or counseling to the best of your ability. This includes an agreement to not omit information relevant to your situation or present inaccurate information. If inaccurate information is provided or important information is purposely omitted, you will not be eligible for a refund if your assessment is not accepted.
FORENSIC DUI.com is not a Government Entity
You understand that FORENSIC DUI.com is not a state or federal organization. While our assessments and clinical reports are generally accepted by other professionals and government agencies you also understand that any clinical conclusions, diagnoses or professional recommendations provided by FORENSIC DUI.com may or may not be accepted or approved by courts, state or federal agencies. Furthermore, courts, state and federal agencies are not bound to agree with our assessments or clinical recommendations.
Refund Terms & Limitations
You understand and agree with our conditions and limits to grant a refund. Refunds are only given in circumstances where the requesting party (court, physician, probation department, etc.) will not accept the assessment we provided and the following procedures are followed:
All refund requests must be initiated through your ndsbs.com account by clicking on “my transactions” and “refund requests” in your account dashboard
All refund requests must be applied for within 45 days of your original registration.
FORENSIC DUI.com will first attempt to contact any third party that does not accept your assessment to see if there is some additional information needed in order to gain acceptance of your report or service. In this circumstance you will need to first sign and return (fax or scan/email) a release of information form to allow your evaluator to speak with the third party.
If we cannot make contact with the requesting party, you must provide written proof that your evaluation was not accepted by the requesting party. The document stating your assessment was not accepted must be on the letterhead of the requesting party and have an address, phone number and contact name included on it.
Refunds are not granted in situations where:
client omitted key information or;
client provided inaccurate information or;
client missed an assessment completion deadline because:
a) FORENSIC DUI.com was not informed of the due date,
b) client did not meet with the evaluator at the originally scheduled time,
c) client did not provide FORENSIC DUI.com evaluator with necessary documents
requested by evaluator or required to be reviewed by the authority
requesting the assessment
client’s assessment was approved initially approved in the original context but not acceptable in another context (Note for example: assessments for court are not guaranteed to be accepted by State Licensing or Motor Vehicle agencies and vice-versa)
client purchased a rush order and report was completed within the timeframe that was ordered (evaluation fee and rush fee are both non-refundable)
all assessments used in context of child custody proceedings are non-refundable (due to the contentious nature of child custody proceedings)
all assessments used to apply for a license reinstatement are non-refundable
all assessments related to safety-sensitive employment are non-refundable services (e.g. aviation/FAA substance abuse evaluations, DOT evaluations, nursing or other medical boards)
we do not refund assessments in situations where you might obtain a new assessment before we have been given the opportunity to seek approval of the assessment we provided
If a portion of your fee was for a rush order, the portion above and beyond the standard fee is NOT eligible for a refund.
If a refund is granted according to our terms and conditions, it will be processed within 15-30 days of the decision date.
If you have obtained a new assessment FORENSIC DUI.com is not responsible for fees for your new assessment. Getting a new assessment or second opinion is not a valid reason to request a refund from FORENSIC DUI.com.
If your appeal for a refund involves a claim that another assessment was immediately required you agree to submit copies of any such subsequent assessment(s) for consideration of your case.
If you have purchased an assessment but do not complete the assessment process you will be refunded under the following conditions and limitations:
Any rush order portion of your fees are not refunded since FORENSIC DUI.com dedicates clinician time for you which they cannot use to perform other assessments
If you have purchased an assessment but not scheduled an interview your account will be charged a $25 administrative fee and the remainder of your funds will be refunded (excluding any applicable rush fees)
If you have scheduled an interview and do not keep the appointed time your account will be charged a $50 no-show and the remainder of your funds will be refunded (excluding any applicable rush fees)
Limits of Electronic Connections and Liability
You understand that there is a chance that internet or phone connection could be lost during your services. In the event your connection is lost, the counselor will attempt to contact you at the number you provided in your registration. If you have not heard from your counselor within five minutes, you agree to call our main number to re-establish connection and plan for continuance of your service. You also agree to hold FORENSIC DUI.com harmless with regard to any and all claims of damage from an electronic disconnection during services (also referred to in the Hold Harmless section of this agreement).
Limited Use of Assessments
You understand and agree that professional assessments prepared for one authority (e.g. a court, a licensing agency, a child services agency, etc.) may not be accepted by another authority. For example, a state licensing agency may require a different reporting format, provider credentials, etc. than a court, therefore making a court assessment unacceptable to their agency. Accordingly, you agree to accurately represent to ndsbs.com what authority is requesting your assessment. (see refund terms and conditions) Furthermore you understand and agree that each requesting authority has their own acceptable timeframe to consider an assessment as valid. NDSBS cannot be held responsible for your submission of an assessment to an authority after what the requesting authority considers a reasonable timeframe.
Respect of Copyrights
All assessment, evaluation, educational and other material made available on our website and provided in our offices is copyrighted. You may use our materials for the purpose of an NDSBS assessment, counseling or education services only. You agree not to use any aforementioned FORENSIC DUI.com materials in any other manner, including copying, reproducing, scanning, distributing, publishing, selling or otherwise conducting commercial activity with NDSBS materials. Efforts to engage in such activity are punishable by state and federal laws.
No Guarantees of Clinical Outcome
You agree that you are using FORENSIC DUI.com services at your own risk and without guarantee of any specific clinical diagnosis or treatment recommendations (education, counseling or other treatment services); that there is no warranty for our services; that third parties are not bound by any contracts or laws to accept or agree with our assessment, evaluation or other clinical conclusions.
Complaints
To file a complaint with us, contact the Director of the practice at:
FORENSICDUI.com, PO Box 13852 Alexandria Louisiana 71315
You will not be retaliated against for filing a complaint.
Acknowledgement of Receipt of Notice of Privacy Practices (HIPAA)
I acknowledge my receipt of New Directions Substance and Behavioral Services’ Notice of Privacy Practices (revised and effective November 8, 2005) . It is included not only in this Consent for Service Agreement (see link) but is also available on our website and in our office for any client to access at any time.
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Disputes and Jurisdiction
Any dispute arising from this Consent for Treatment and Terms of Use Agreement shall be governed by the laws and jurisdiction of the State of Louisiana.
Notice of Changes
FORENSIC DUI.com may notify clients of changes or additions to its services by publishing such notice on the FORENSIC DUI.com website. Clients may give notice to FORENSIC DUI.com at any time by any of the following:
Email: admin@harveynorris.com
Modifications / Entire Agreement
This Agreement constitutes the entire agreement between you, the client, and NDSBS. The content represented herein supersedes all previous written or verbal terms of use agreements. FORENSIC DUI.com may amend, modify, clarify, or remove any part of this agreement with notice through the ndsbs.com website. Any use of FORENSIC DUI.com services by you after any amendments, modifications, clarifications, or deletions shall be deemed to constitute acceptance by you of the updated terms of the agreement. You understand that if a court deems any part of this agreement to be illegal or a violation of Ohio statutes, the remaining parts of the agreement shall be considered valid and enforceable until proven otherwise in an Ohio court of law.
By signing in person or clicking on the "agree" button below this Consent for Service, this Limits and Terms of Use Agreement shall be construed and controlled by the applicable laws of the state of Louisiana and the United States of America.