A Medical History Form MUST be filled out prior to your first session and it is your responsibility to make sure I am kept updated on your current health status.
I am required by law to inform you that your medical information is guarded under "The Health Information Portability and Accountability Act of 1996 (HIPAA)" and it requires all your care records and other individually identifiable health information (protected health information) used or diclosed to me in any form, whether electronically, on paper, or orally, be kept confidential. This federal law gives you, the patient, significant rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse health information. As required by HIPAA, I have prepared this explanation of how I am required to maintain the privacy of your health information and how I may use and/or disclose your health information ONLY with your written permission. For further information, please feel free to ask.