Patient Intake Privacy Notice
Effective Date: January 1, 2024
This Notice explains how intake information is collected and protected.
Information Collected
- Personal identification
- Medical history and symptoms
- Insurance information
- Emergency contacts
How Information Is Used
To evaluate your condition, develop treatment plans, verify insurance, and maintain clinical records.
HIPAA-Compliant Storage
All patient intake information is stored securely in compliance with HIPAA.
Sharing of Information
We may disclose information to:
- Insurance providers
- Other healthcare professionals (with authorization)
- Legal authorities when required
We do not share information for marketing without your written consent.