Our practice is dedicated to maintaining the privacy of your individually identifiable health information. In conducting our business, we will create records regarding you and the treatment and services we provide you. We are required by law to maintain the confidentiality of health information that identifies you.
We will use and disclose your protected health information with only the physicians you list below. We will also use and disclose your protected health information to obtain payment for health care services we provide you. We have our office policy regarding all the ways we will keep your information private posted in our office and a copy is available on request.