Modern, relationship-based primary care with convenient in-person and virtual visits.
Describes how health information about you may be used and disclosed, and how you can access your individually identifiable health information. Please review this notice carefully.
Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.
All patients must provide consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility.
Patients are encouraged to complete and return this form but it is not required.
Advises patients of their complete financial responsibility for all medical services received, regardless of insurance eligibility or coverage.
Advises patients of language services availability
