6 Pa. Code § 11.103 - Enrollment agreement

(a) The center shall develop an enrollment agreement and discuss it with the client or the responsible party, or both. The enrollment agreement shall include at least the following elements:

(1) The available services and goals of the center.

(2) The unit of charges and when it is payable.

(3) Conditions for termination from service, or discharge.

(4) The center's rules and regulations.

(5) The release of information form giving the center permission to share limited treatment and diagnostic information with third-party payors for purposes of reimbursement and to transfer the client's records to another facility if the client transfers from the center to that facility.

(b) The center is responsible for completing the enrollment agreement with the client or responsible party, or both, and shall review and explain its contents to the client or responsible party, or both, prior to signature. Upon acceptance of the terms and conditions in the enrollment agreement, the enrollment agreement shall be signed by the program director/administrator, the client or the responsible party, or both.

(c) The client or the responsible party, or both, shall receive a copy of the signed enrollment agreement and a copy of the center's grievance procedures as set forth in § 11.20 (relating to grievance procedures) and client bill of rights.

Notes

6 Pa. Code § 11.103

This section cited in 6 Pa. Code § 11.191 (relating to emergency information); and 6 Pa. Code § 11.212 (relating to applicability).