Change of Practice Account Owner Procedure

Prerequisites

Before initiating a practice Account Owner transfer, ensure the following requirements are met:

• Incoming Owner Must Have Existing Access: The incoming practice Account Owner must already have an established user account within your practice’s TherapyAppointment account.
• Legal Authority Required: The incoming owner must have legal authority to bind the organization to agreements and accept compliance obligations.
• Current Owner or Authorized Representative: Requests must be initiated by either:
  • The current designated practice Account Owner, OR
  • An authorized representative with legal documentation

Special Circumstances

If the current practice Account Owner is unavailable due to death, incapacity, or unresponsiveness, additional legal documentation will be required. Please contact TherapyAppointment support before beginning this process to determine what documentation is needed.

Submit Written Request

All practice Account Owner transfer requests must be submitted in writing through the TherapyAppointment customer support portal. At the bottom right click the question mark icon, then email (also on this page).

Include in Your Request:

• Current practice Account Owner name
• Incoming practice Account Owner name
• Any relevant legal documentation (if applicable)

Once your request is received and verified, TherapyAppointment will initiate the identity verification process and send DocuSign forms to both parties.

Identity Verification Requirements

Process Overview

A DocuSign form will be sent to both the current practice Account Owner and the incoming practice Account Owner. This form allows the current practice Account Owner to release their account ownership rights in the TherapyAppointment application and have them reassigned to the designated incoming practice owner.

Both parties will need to verify their identification online using one of the following:

• Valid passport,
• Valid driver’s license, or
• Valid state-issued ID

The legal name from your selected ID will be pre-populated on the DocuSign Form.

Complete DocuSign Form

Each party (the outgoing practice Account Owner and the incoming practice Account Owner) will complete the following process.

Initial Access (Laptop/Desktop Recommended)

1. Check your email for a messages from DocuSign:
   1. The “TherapyAppointment Change in Ownership” Form” email
2. Open the form email and e start the process.
   1. Click the link in the email to “Review Document.”
   2. Click “I Agree” to begin the identity verification process.
   3. Select the country or region associated with your ID.
   4. Choose your ID type.
   5. Click “I Agree” for the use of Docusign’s identity verification partner Onfido.
   6. Enter your mobile phone number or scan a QR code with your mobile device when prompted.
   7. You will receive a link or be taken to a site to complete identity verification using your mobile device’s camera.
   8. Continue the instructions for your mobile device in the next section. DO NOT close the current page on your computer.

Identity Verification (Mobile Device Required)

Complete the following steps on your mobile device with camera access.

1. Click “continue” to allow camera access.
2. Photograph your valid ID
   1. Take clear photo(s) of your driver’s license, passport, or state-issued ID
   2. Ensure all information is legible
3. You may be asked to record a facial verification video. If so:
   1. Complete a brief facial video to validate against your ID/Passport
   2. Follow the on-screen prompts
4. When your mobile device shows “We have verified your identity,” return to your computer to complete the next portion.

Complete the DocuSign Form (Laptop/Desktop Recommended)

Upon successful identity verification, you will be directed to the DocuSign form. After you agree to the use of electronic records and signatures, you will complete or verify the following applicable process for your party:

Part 1: Current Practice Account Owner/Transferor Information Required

1. Click “Start” to begin.
2. Current Practice Name
3. New Practice Account Owner Name
4. Four (4) Acknowledgements via Initials of Current Practice Account Owner
   1. I am the current owner …
   2. Transfer acknowledgement to the person listed above (ref #2)...
   3. Acknowledge what rights and access-rights are being given…
   4. Acknowledge that you will no longer have access-rights…
5. Current Practice’s Account Owner Name [This will auto-populate based on eVerification]
6. Digital Signature of Current Practice Account Owner
7. Date of Signature [This will auto-populate to the current date.]

Once you finish, you have an option to “save a copy” of the form. You also have the option to create a DocuSign account to access a copy of the form at any time.

Part 2: Incoming Practice Account Owner/Transferee Information Required

1. Click “Start” to begin.
2. Digital Signature of Incoming Practice Account Owner
3. Date of Signature [This will auto-populate based on the current date.]
4. Incoming Practice Account Owner’s Name [This will auto-populate based on eVerification]
5. Email Address of Incoming Practice Account Owner [This will auto-populate to the address on file for your TherapyAppointment account.]
6. Phone Number of Incoming Practice Account Owner
7. Mailing Address of Incoming Practice Account Owner
8. Name of the practice as the corporate entity. [This will only be Populated if it is an Authorized individual signing for a company.]

Once you finish, you have an option to “save a copy” of the form. You also have the option to create a DocuSign account to access a copy of the form at any time.

Additional Notes

We will provide both parties with a copy of the digitally signed document via email for your records.