Download HIPAA Forms

Due to the  Health Insurance Portability and Accountability Act of 1996 (HIPAA) we require our customers to download compliance document, and carefully read, print, sign and submit it to us via Mail or Fax.

As a HIPAA compliant company we are obligated to protect all your personal information, including your medical records. These will be kept confidential, and will never be shared or sold to third parties.

Please use the Reference Code provided by your agent.

Please click HERE to download the Patient Registration Form package.

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