PLEASE MAKE SURE TO READ OVER THE FORM AND FILL IN AS MUCH INFORMATION AS YOU CAN ABOUT INSURANCE, CONTACT INFORMATION, AND HEALTH HISTORY. WHEN YOU COME IN THE OFFICE YOU WILL SIGN THAT YOU UNDERSTAND AND HAVE BEEN AWARE OF THE HIPAA POLICY AND UNDERSTAND THAT YOU ARE FINANCIALLY RESPONSIBLE FOR ALL CHARGES WHETHER OR NOT PAID BY INSURANCE.
BE SURE TO GIVE US AS MUCH MEDICAL HISTORY AS POSSIBLE.
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