Formal Complaint Form

We are required by applicable federal and state law to maintain the privacy of your health information.

We are also required to give you this Notice about the use and disclosure of your health information (1), our legal responsibilities (2), and your rights concerning your health information (3).

We reserve the right to change our privacy practices provided such changes are permitted by applicable law.  Before we make a significant change in our privacy practices, we will change this Notice and make a new Notice available upon request.  We are required to abide by the terms of the Notice currently in effect.