Patient Info

For your convenience, many of our required forms can be downloaded to review and complete in advance.

Links to patient forms

Notice of Privacy Practices

It is the policy of our practice that all physicians and staff preserve the integrity and the confidentiality of protected health information pertaining to our patients.  The purpose of this policy is to ensure that our practice and its physicians and staff have the necessary medical and protected health information to provide the highest quality medical care possible while protecting the confidentiality of the protected health information of our patients to the highest degree possible.  Patients should not be afraid to provide information to our practice and its physicians and staff for purposes of treatment, payment and healthcare operations. To that end, our practice and its physicians and staff will:

  • Adhere to the standards set forth in the Notice of Privacy Practices.
  • Collect, use and disclose protected health information only in conformance with state and federal laws and current patient covenants and/or authorizations, as appropriate.  Our practice and its physicians and staff will not use or disclose protected health information for uses outside of practice’s treatment, payment and healthcare operations, such as marketing, employment, life insurance applications, etc. without an authorization from the patient.
  • Use and disclose protected health information to remind patients of their appointments unless they instruct us not to.
  • Recognize that protected health information collected about patients must be accurate, timely, complete, and available when needed.  Our practice and its physicians and staff will:
    • Implement reasonable measures to protect the integrity of all protected health information maintained about patients.
    • Recognize that patients have a right to privacy.
  • Respect the patient’s individual dignity at all times.
  • Respect patient’s privacy to the extent consistent with providing the highest quality medical care possible and with the efficient administration of the facility.
  • Act as responsible information stewards and treat all protected health information as sensitive and confidential.
  • Consequently, our practice and its physicians and staff will:
    • Treat all protected health information data as confidential in accordance with professional ethics, accreditation standards, and legal requirements.
    • Not disclose protected health information data unless the patient (or his or her authorized representative) has properly authorized the release or the release is otherwise authorized by law.
  • Recognize that, although our practice “owns” the medical record, the patient has a right to inspect and obtain a copy of his/her protected health information.  In addition, patients have a right to request an amendment to his/her medical record if he/she believes his/her information is inaccurate or incomplete. Our practice and its physicians and staff will:
    • Permit patient’s access to their medical records when their written requests are approved by our practice. If we deny their request, then we must inform the patients that they may request a review of our denial.  In such cases, we will have an on-site healthcare professional review the patients’ Appeals.
    • Provide patients an opportunity to request the correction of inaccurate or incomplete protected health information in their medical records in accordance with the law and professional standards.
  • All physicians and staff of our practice will maintain a list of certain disclosures of protected health information for purposes other than treatment, payment and healthcare operations for each patient and those made pursuant to an authorization as required by HIPAA rules.
  • We will provide this list to patients upon request, so long as their requests are in writing.
  • All physicians and staff of our practice will adhere to any restrictions concerning the use or disclosure of protected health information that patients have requested and have been approved by our practice.
  • All physicians and staff of our practice must adhere to this policy. Our practice will not tolerate violations of this policy. Violation of this policy is grounds for disciplinary action, up to and including termination of employment and criminal or professional sanctions in accordance with our practice’s personnel rules and regulations.
  • Our practice may change this privacy policy in the future.  Any changes will be effective upon the release of a revised privacy policy and will be made available to patients upon request.
Telehealth Services are available now.

You can schedule an office visit with your doctor over your phone or computer. Please call us at 406-363-3627 if you would like to set up a Telehealth visit with your doctor. All you need is a smart phone or a computer/laptop with an email account.