Many of these documents are in pdf format and will require the Adobe Acrobat reader to view them.
Notice of Privacy Practices 
Notice describing the company's policies regarding customer's personal health information.
Authorization
Form to be completed by customer to request that individually identifiable health information be received or disclosed by a specified person or entity.
Request for Access to Designated Records
Form to be completed by customer to request access to the health information contained in the records maintained by the Company.
Request for Restrictions
Form to be completed by customer to request restricted uses or disclosures of protected health information.
Request for Confidential Communications
Form to be completed by customer to request an alternative means of communicating protected health information.
Request for Amendment to Designated Records
Form to be completed by customer to request that the health information contained in the company's records be amended.
Request for an Accounting
Form to be completed by customer to request an accounting of the disclosures made by the Company of customer's protected health information.
Complaint under Privacy Rule
Form to be completed by anyone wishing to file a complaint against the Company's actions, policies or procedures with respect to the Privacy Rule and/or individually identifiable health information.
Contact Us
If you have any questions or concerns, please contact the privacy officer.