Privacy Notice

     The Health Insurance Portability Accountability Act of 1996 (HIPAA) requires that we receive your permission before we use the persoanl information in your medical records for any reason.

     The signed consent form gives us permission to use your Protected Health Information (PHI) to carry out treatment, receive and/or a part of health care operations of our practice.

     HIPAA also requires us to have a written notice of our privacy policy describing how medical information about youmay be used and disclosed.  If you so desire, this written notice is available at the front desk.

     You have the right to revoke, in writing, this consent form at any time, although any services performed prior to the revocation of this consent are covered by this consent.

Release of X-Rays and/or Paper Records

Due to strict Federal HIPAA regulations our office must and will forward all patient records directly to the facility requesting our patients' records providing a signed HIPAA compliant form has been signed and witnessed, and accompanies the request.  We cannot release records to the patient directly.

We will forward your records via USPS but will not release directly to the patient.