Our office adheres to the requirements outlined by the Health Insurance Portability and Accountability Act (HIPAA), which ensures the security and privacy of an individual’s medical records and promotes privacy and trust between patients and their healthcare providers.
As part of HIPAA requirements, all new patients seeing their healthcare provider upon their initial visit are required to sign an acknowledgment form to indicate that they have received the Privacy Notice. The Privacy Notice describes how the hospital/provider uses and shares your personal health information.
Call or e-mail us for more information about your privacy rights as a patient.
Please fax to (281) 304-9930
– This form is a standard form letting you know your privacy rights.
– This form is to be filled out prior to your visit.
– This form is your confidential medical history; please fill it out completely.
16316 Spring Cypress Rd, Cypress, TX 77429
Email: firstname.lastname@example.orgBook Now
16316 Spring Cypress Rd,
Call or Text Us: (281) 304-9911