I have downloaded and read the Business Policies and Informed Consent,
the Financial Agreement, and the HIPAA Notice documents available on https://www.drmayaklein.com
and I agree and consent to all policies. I have had the opportunity to
ask questions about all policies. I understand that Dr. Maya Klein may
use an insurance billing company to submit my information if I am using
insurance, and that I will receive either post or email billing at the
addresses provided above containing my statements.