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Privacy Policies

 

ALL documents are in PDF format

HIPAA Privacy Policies (109Kb)
Form A: Patient Access to Records Request Form (62Kb)
Form B: Authorization for Release of Health Inforamtion (77Kb)
Form C: Accounting of Disclosures Request (62Kb)
Form D: Disclosure Tracking Log (81Kb)
Form E: Amendment/Correction of Health Record Request (64Kb)
Form F: Restriction of Use and Disclosures Request (59Kb)
Form G: Request for Confidential Communications (60Kb)

Notice of Privacy Practices (25Kb)


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