Eclipse Mental Health Services

Compliance Policy

Please correct the errors described below.

The following is required to fulfill your compliance requirements. Please initial after each statement demonstrating that you read and understand the requirement:

The Following NON-compliance may result in immediate dismissal or tapering/discontinuation of current medication regimen:

If any compliance requirement is violated you will be required to review and sign a compliance violation log. If you refuse to do this you will be dismissed immediately.

DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

Your information will be encrypted.