Putting the Family back in Family Practice

Notice and Acknowledgement of Privacy Practices for Protected Health Information:

http://www.freewebs.com/drmaryk/Notice of Privacy Practices for Protected Health Information.doc

http://www.freewebs.com/drmaryk/Acknowledgment of Receipt of Notice of Privacy Practices.doc

Records Request:

http://www.freewebs.com/drmaryk/Authorization for the Use or Disclosure of Protected Health Information.doc

Financial Policy Acknowledgement:

http://www.freewebs.com/drmaryk/Financial policy.doc

Informed Consent:

http://www.freewebs.com/drmaryk/Informed consent.doc

New Patient Information Record:

http://www.freewebs.com/drmaryk/New Patient Information Record-Adult.doc

http://www.freewebs.com/drmaryk/New patient information record-pediatrics.doc

Reduced Fee Application:

http://www.freewebs.com/drmaryk/Reduced Fee Application.doc