Patient Registration & Medical History
Save time at your visit by completing this form online. All information is transmitted securely and protected under HIPAA.
HIPAA Compliant
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BAA on File
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Your Privacy is Protected
All online forms are processed through a HIPAA-compliant platform with a signed Business Associate Agreement (BAA). Your Protected Health Information (PHI) is encrypted during transmission and at rest, and is never stored on our website servers.
We comply with all HIPAA Privacy and Security Rules to safeguard your medical information.
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If you have questions about the form or need assistance, our team is here to help.