[et_pb_section fb_built=”1″ _builder_version=”4.10.8″ _module_preset=”default” locked=”off” global_colors_info=”{}”][et_pb_row _builder_version=”4.10.8″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.10.8″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.10.8″ _module_preset=”default” text_font=”Poppins||||||||” header_font=”Montserrat||||||||” header_3_font=”Poppins|600|||||||” header_3_text_color=”#000000″ header_3_font_size=”36px” hover_enabled=”0″ text_font_size_tablet=”” text_font_size_phone=”16px” text_font_size_last_edited=”on|phone” header_font_last_edited=”off|phone” header_3_font_size_tablet=”” header_3_font_size_phone=”26px” header_3_font_size_last_edited=”on|phone” global_colors_info=”{}” sticky_enabled=”0″]<\/p>\n
Forms can be completed online through the\u00a0<\/span>patient portal<\/a>\u00a0or you can print them from our website and bring them with you to your appointment.<\/span><\/p>\n<\/div>\n<\/div>\n Authorization for Release of Medical Information (PDF)<\/a>\u00a0<\/span>\u2013 Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.\u00a0<\/span>Autorizaci\u00f3n De HIPAA Para Divulgar Informaci\u00f3n Del Paciente<\/a><\/p>\n Authorization and Consent for Treatment (PDF)<\/a>\u00a0<\/span>\u2013 All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility.\u00a0<\/span>Autorizaci\u00f3n y Consentimiento Para el Tratamiento<\/a><\/p>\n Preferred Contacts (PDF)<\/a>\u00a0<\/span>\u2013 Patients are encouraged to complete and return the Preferred Contacts Form but it is not required.\u00a0<\/span>Contactos Preferidos<\/a><\/p>\n Virtual Visit Policy (PDF)<\/a>\u00a0<\/span>\u2013 This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.<\/p>\n<\/div>\n<\/div>\n <\/a><\/p>\n Financial Policy (PDF)<\/a>\u00a0<\/span>\u2013 This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations.\u00a0<\/span>Pol\u00edtica Financiera (PDF)<\/a><\/p>\n Notice of Privacy Practices (PDF)<\/a>\u00a0<\/span>\u2013 Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully.\u00a0<\/span>Aviso de pr\u00e1cticas de privacidad (PDF)<\/a><\/p>\n<\/h3>\n
Office Policies<\/h3>\n