Your privacy is import to us
At Atlanta Endodontics, your privacy is important to us. At your initial visit, and in accordace with federal law, you will be asked to sign a HIPAA relase form. This will allow us to effectively communicate with your refering office. If there are other individuals, such as a spouse, any other family member, or friend that you would like for us to be able to speak to, please indicate this in the appropriate area on the HIPAA form.
A-17 form, Patient Authorization for Use and Disclosure of Protected Health Information
Wow, that title is a mouthful! What it means is that now, in accordance with Federal law, in order for us to be able to communicate with your referring Dentist or Dental specialist, you must fill out and sign form A-17. If there are other individuals such as a child, spouse or parent that you wish for us to speak to on your behalf, please indicate their name and describe in detail the information to disclosed.