Doctors are required by the new Federal HIPPA laws to adhere to the highest privacy standards possible in order to protect patient confidentiality. We have provided this secure, confidential environment for you to conveniently complete your Patient Registration with us before your appointment. Please fill out the following form which we will print, have you sign when you arrive at our office and keep on record in our confidential files.

In general, the HIPAA privacy rule gives individuals the right to request a restriction on uses and disclosures of their protected right to request confidential communications or that a communication of PHI be made by alternative means, such as sending correspondence to the individual’s office instead of the individual’s home.