Privacy Policy (HIPAA)

New patients should review our privacy policy.  It details how we protect you and your child's private medical information.  You can print it out or review it onscreen.  Then fill out the Notification of HIPAA Practices form below to sign and bring to your first appointment.

Download our privacy policy.

 
Notification of Receipt of HIPAA Practices

Download and print out this form after reviewing the HIPPA policy above.  By federal law, all patients must have this form in their chart to show they are aware of the steps our practice takes to protect their private medical information.

Download notification of receipt of HIPAA policy

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New Patient Information Form

New patients can download this form and bring it to their first appointment.  It asks about your child's past medical history including birth history, illnesses, surgeries, allergies and family history.  This information will be reviewed by the doctor or nurse practioner at your child's first visit.

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Download the new patient information form.

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