Privacy Forms

Recent changes in the law require us to provide you with our privacy policy prior to downloading any forms from our site.

In addition, we are required by applicable federal and state laws to maintain the privacy of your protected health information. We are also required to give you this notice about our privacy practices, our legal duties, and your rights concerning your protected health information. We must follow the privacy practices that are described in this notice while it is in effect. This notice takes effect April 14, 2003, and will remain in effect until we replace it.

We reserve the right to change our privacy practices and the terms of this notice at any time, provided that such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our notice effective for all protected health information that we maintain, including medical information we created or received before we made the changes.

You can download our privacy policies here:

Patient Registration Form
English: NEW_PATIENT_FORMS-ENGLISH-072117
Spanish: NEW_PATIENT_FORMS-SPANISH-072117

No Show Policy Form
English: ENG No Show
Spanish: SPAN No Show

Medical Record Release Form

Notice of Privacy Practices

Quick Reference Regarding Disclosures Requiring/Not Requiring Written Patient Authorization

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