NOTE: These are private practice forms only. I am no longer in private practice, but previous patients may need to access these forms with respect to past care. See Legacy Health at www.legacyhealth.org for forms and contact information for medical releases regarding my work there.

1. HIPAA: This form details my privacy policies and practices. 

2. Authorization Form: You may use this form to request that health records be sent to 
    or from my office.







 
 
  Site Map