Federal law requires that I provide every patient with this Notice Of Privacy Practices. It explains how I may use and disclose your health information under the guidelines established by the Health Insurance Portability and Accountability Act of 1996 (aka "HIPAA"). It also explains my duty to protect and secure your health information and your rights to file a complaint if you feel your privacy rights have been violated.
All patients are asked to sign the Notice of Privacy Practices before any medical advice or services are provided. Signing the form simply acknowledges your receipt of the Notice. It does not mean you have agreed to any special uses or disclosures of your health information. However, the notice has been appended to allow you to specify with whom (mom, dad, step-parent, grandparent, nanny, etc.) and how (phone, text, email, snail mail, etc.) I may discuss or disclose any medical information related to your child. This information is the most important to me. Please take the time to complete it carefully and legibly (it is an Adobe pdf file - if you have Adobe, you can download it and print it out). Thank you.
Notice of Privacy Practices