|Purpose / Description|
|New Patient Forms||General information needed for each new patient... i.e - Name, Address, City, State, etc...|
|Credit Card on File Policy||This form allows the office to keep a form of payment on file so that any balances unpaid by insurance can be promptly taken care of, eliminating the need for mailed in or phoned in payments.|
|Medical Records Release||Allows you to give us the legal right to release sensitive Health Information to other health providers...|
|HIPAA Authorization||This form grants us permission to discuss your medical care and/or leave phone messages regarding your care only (and ONLY) with the people you list. This includes your health information, laboratory results, test results & financial information.
HIPAA - Health Information Portability & Accountability Act
|Female Health Assessment Questionnaire||This female BioIdentical Hormone Questionnaire gives us both a good indication as to whether or not our RightBalance Hormone replacement therapy might be of help...|
|Male Health Assessment Questionnaire||This male BioIdentical Hormone Questionnaire gives us both a good indication as to whether or not our RightBalance Hormone replacement therapy might be of help...|