Call Recording & Billing Acknowledgement Form
I hereby acknowledge that Psychiatrists.com may record inbound calls for quality and training purposes. Only those calls to specifically assigned ad-tracking telephone numbers may be recorded. Calls from current or prospective patients may be recorded. I understand that other than myself and Psychiatrists.com staff, only others I give access to may review recorded calls. Psychiatrists.com, in agreement with CallSource.com, provides a telephone call recording feature known as CallReview. In compliance with all HIPAA policies, Psychiatrists.com provides a pre-recorded notice to callers and requires a signed consent form from each Subscriber that an ad-tracking telephone number is assigned to. The Subscriber can choose to provide their employees access to review the recorded calls without providing a consent form for each employee to Psychiatrists.com. Subscriber understands and acknowledges that Psychiatrists.com is now relying on Subscribers fulfillment to comply with these terms. Subscriber agrees to pay a flat rate of 30 dollars (USD) for only the call recordings resulting in an appointment being scheduled with the Subscribers office, with a limit of 1 charge per patient. Further, Subscriber agrees to indemnify and hold Psychiatrists.com harmless in the event of any complaint, claim, penalty, fine, or action brought against Psychiatrists.com as the result of Subscriber providing said recording service to any of Subscribers Clients.

I Agree to the terms and conditions of creating my account (Check Box) *