Please complete and submit these HIPPA forms prior to your child/children’s well visit each year. There are 2 forms that need to be completed – Financial Policy and HIPPA Privacy Practices.
Click to Acknowledge 2026 Financial Policy AND Credit Card on File Secure Form.
OR
Click to Acknowledge the 2026 Financial Policy ONLY (if you already have a credit card on file with us)
AND ALSO
Click to Acknowledge 2026 HIPPA Privacy Practices