Notice of Privacy Practices
Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information.
Authorization for Release of Medical Information
Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.
Authorization and Consent for Treatment
All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility.
Preferred Contacts
Patients are encouraged to complete and return the Preferred Contacts Form to personalize their communication preferences, but submitting the form is optional and not necessary to access our clinic’s services.
Financial Policy
This form informs patients that they are fully responsible for payment of all medical services provided, regardless of insurance eligibility, plan coverage, or denial of claims or benefits.
Notice of Nondiscrimination
Notice of Nondiscrimination page declares the organization does not discriminate based on race, color, national origin, age, disability, or sex, following federal law.
