Privacy Policy

Although physicians have a 4000-year tradition of maintaining patient confidentiality, the United States Congress enacted the Privacy Act of 2001. This law governs how health care providers must store, secure, and transmit personal health information. Physicians are required to give their patients certain notices and to receive certain instructions from their patients indicating how they want the doctor and the office staff to handle their personal health information. This website provides the necessary documents to review and sign by the time of your first office visit, so you can complete these forms at your own convenience.

The law requires us to provide our patients with a NOTICE OF OUR PRIVACY PRACTICES upon their first visit after April 14, 2003. The law also requires physicians to document that we have provided this notice and that our patients consent to our privacy practices.

• Please view and read either the 1 page ABRIDGED NOTICE OF PRIVACY PRACTICES or the 9 page COMPLETE NOTICE OF PRIVACY PRACTICES.
• Please download, print, and sign the document entitled CONSENT TO PRIVACY PRACTICES. Also, please indicate whether you read the abridged or complete version of the notice.
• Please bring the signed document to the office and provide it to the receptionist.

If you do not agree with the privacy practices of this medical practice, or if you do not wish to sign consent for our privacy practices, Federal law does not allow the doctor to see you.

The law permits the doctor to use your personal information for treatment, payment, and operational purposes. The law does not permit the doctor to discuss or share your personal health information with your spouse, children, or any other concerned individual without your specific written authorization. The doctor's office has no way to verify which parties may be the legitimate recipients of such information about your case, unless you provide information to us. Accordingly, please find the form entitled SURROGATE - TELEPHONE AUTHORIZATION.

• Please download the form, print it, and fill in the names of those people with whom we can communicate if you are incapacitated or unavailable to communicate. You may have concerned relatives in town or out of town who call and want to speak to the doctor about your condition, but the Privacy Act forbids the doctor's office to speak about your condition with anyone whose name is not on the list.
• Also, if you wish to permit us to leave telephone messages for you on your answering machine or voice mail, please initial and date the second page of this form in the designated area.
• Please bring the signed form to the office at the time of your first visit and provide it to the receptionist. If you have questions about the form, the receptionist will be glad to help you.

We are firmly committed to preserving your privacy and confidentiality. The Privacy Act requires us to have these signed documents on file in the medical chart of every patient we see after April 14, 2003.