Privacy Policies

The following documents summarize our policies to protect your privacy in regards to your children's medical histories.  We are fully compliant with the new HIPAA regulations as specified by the government.  For full HIPAA information and regulations, see: http://www.cdc.gov/nip/registry/pcs.htm#1.

We will need the following documents (marked by an *) read and an acknowledgement form filled out when you come into the office for the first time. You can save time if you print them here, read, and sign the form, and bring them with you to the office.

Privacy Documents (in .pdf format)                                             

• Notice of Privacy Policies  *               
• Authorization to Disclose Health Information *
• Acknowledgement Form *
• Notice of Disclosure to Employers
• Request for Medical Record Release
• Release of Confidential HIV Related Information
• Revocation of Medical Record Release form
• E-mail policy *
• Authorization to Use Photographs

Copyright Kids Care Pediatric Associates, P.C. 2009© 
For problems or questions regarding this web contact info@kids-care.com.
Last updated: March 17, 2010.