Step 1: Download this form and read thoroughly for your right to privacy under HIPAA: HIPAA Notice Brochure
Step 2: Please eSign this form and save it to your computer, or print, sign and scan this form to your computer. You will need to upload it to the form below: HIPAA Acknowledgement Form
Please print and complete the appropriate forms below. Please email them to firstname.lastname@example.org and bring them to your first appointment. If you have any questions, please arrive a few minutes early so our staff can assist you.