Privacy Statement

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review carefully.


General Rule


We respect our legal obligation to keep health information that identifies you private. We are obligated by law to give you notice of our privacy practices.

Generally, we cannot use your health information in our office or disclose it outside of our office without your written permission. Sometimes the written permission will be called a consent form, and sometimes it will be called an authorization form. The type of permission form will depend upon the kinds of uses or disclosures that are involved. In some limited situations, the law allows or requires us to disclose your health information without either a written consent or authorization.


Uses or Disclosures with Consent


We will ask you to sign a consent form allowing us to use and disclose your health information for purposes of treatment, payment, and health care operation of this office. We are allowed to refuse to treat you if you do not sign the consent form.