Privacy Forms (HIPAA)

    To submit privacy consent form digitally, fill out this form:

    Notice of privacy practices (HIPAA)

    I understand that your privacy is important.  Your information will only be used for billing or, with your permission, to communicate with other people (e.g. doctors or family members).

    Your right to privacy is protected by law under HIPAA, the Health Insurance Portability and Accountability Act of 1996.

To download and print HIPAA documents click on the links below:

Notice of privacy practices (HIPAA)

I understand that your privacy is important.  Your information will only be used for billing or, with your permission, to communicate with other people (e.g. doctors or family members).

Your right to privacy is protected by law under HIPAA, the Health Insurance Portability and Accountability Act of 1996. For more information, please refer to the HIPAA documents linked below.