HIPAA Notice and Consent to Share Information
Updated May 13, 2021
Click on the form you wish to review. The notice on the left is required by the Federal government and explains how your health information is protected. You can download and print a copy for your records. The form on the right should be completed only if you want us to share information with other people, such as practitioners, partner, family, etc. Fill out sections A and B and the lower section. TO PRINT ANY FORM IT IS BEST TO (1) FIRST DOWNLOAD THE FORM TO YOUR DESKTOP, AND (2) THEN PRINT FROM YOUR DESKTOP.
Hit the ESCAPE button to EXIT after form opens.