Questions?

Collaborative Care Agreement – N&S Clinic LLC d/b/a Your Infinity Health (“YIH”, “we”, “us”, or “our”), N&S Clinic LLC is the legal entity operating the telehealth platform known as Your Infinity Health.

I consent to receive Collaborative Care Services through Your Infinity Health or its contracted affiliates. I understand that this means my primary provider, behavioral health manager and a psychiatric specialist or addiction specialist (as applicable) will communicate with each other regarding my plan of care.

I understand that through my participation in this program, my behavioral health manager will communicate with me on a regular basis to monitor my progress and provide therapeutic interventions as needed.

I acknowledge that I am providing this consent voluntarily and that I may terminate my participation in the collaborative care program at any time by informing the practice.

All communications among care team members are handled in accordance with YIH’s HIPAA-compliant Notice of Privacy Practices.