Appointment Reminders. We may use health information about you to provide appointment or prescription reminders.
Appointment Reminders. Our practice may use and disclose your IIHI to contact you and remind you of an appointment.
Appointment Reminders. The Practice may use and disclose your PHI to contact you and remind you of an appointment.
Appointment Reminders. We may use and disclose medical information to contact you to remind you that you have an appointment for treatment or medical care.
Appointment Reminders. We may use or disclose your health information for purposes of contacting you to remind you of a health care appointment (i.e., voicemail messages, postcards, email, or letters).
Appointment Reminders. We may use and disclose your health information to remind you about appointments you have made to receive health care services or to encourage you to make such appointments.
Appointment Reminders. Our organization may use and disclose your identifiable health information to contact you and remind you of visits/deliveries.
Appointment Reminders. Our practice may use and disclose your PHI to contact you and remind you of an appointment. This includes the leaving of appointment reminder information on your telephone answering machine, SMS, or email.
Appointment Reminders. As a courtesy to our patients, we attempt to contact you two days before your scheduled appointment to remind you of the appointment date and time. However, it is your responsibility to keep up with your scheduled appointments. If, due to technical difficulties or unforeseen circumstances, we are unable to give you a reminder, you are still responsible for keeping your appointment and will be charged for a late cancellation or no-show according to the schedule listed on the Credit Card Agreement. Please let us know how you would like to receive your appointment reminders (choose one): By telephone. Please give us the best number to contact you. By giving us this number, you also give us consent to leave a voicemail or message if you do not answer. Best telephone number: ( ) By email. Please give us the best email to contact you. By giving us this email, you acknowledge that email is not a secure form of communication and absolve us from any liability should it be intercepted, hacked, or otherwise compromised and your confidentiality broken. Best email: I do not wish to receive appointment reminders. Primary Care Physician Information: Name Address Phone How long have you been a patient of this physician? For purposes of continuity of care, may we contact your physician to let him/her know of your visit? Yes No If yes, I give permission to to send a general statement notifying my primary care physician of my visit today. The information sent will be used for coordination of care, and will be limited to a brief description of the problem area and/or diagnosis, and a general outline of treatment. Patient Signature Date Acknowledgments: Please discuss any questions or concerns with your therapist. Your signature below indicates that you consent for us to treat you, that you understand and agree with the terms of the Psychological Services Agreement, and that you acknowledge receipt of the HIPAA Notice: Client Name (please print) Client Signature Date If Applicable: Parent/Legal Guardian Name (please print)
Appointment Reminders. If Schedule “A” to the RCM Agreement indicates that MMBS is to provide Appointment Reminder Services to Medical Practice then Medical Practice shall provide each Patient’s name, phone number and any other appointment related information reasonably requested by MMBS to MMBS at least one (1) business day following the making of each Patient appointment with Medical Practice. If Schedule “A” to the RCM Agreement indicates that MMBS is to provide Appointment Reminder Services to Medical Practice then Medical Practice hereby authorizes MMBS to contact Medical Practice’s patients to provide the Appointment Reminder Services. Medical Practice acknowledges and agrees that MMBS makes no warranties of any kind regarding the provision of Appointment Reminder Services and that MMBS has no liability of any kind relating to the Appointment Reminder Services, including, without limitation, no liability with respect to any Patient that does not receive an appointment reminder or any patient that does not keep a scheduled appointment. MMBS may elect to cease providing Appointment Reminder Services to Medical Practice for any reason following written notice of such cessation to Medical Practice.
