Please Keep Website Messages General
The contact and appointment-request forms on this website are designed
for basic communication and scheduling requests. Unless a form is
specifically identified as part of an approved secure patient system,
please do not use it to send detailed or sensitive health information.
Do not include information such as:
- Detailed medical histories or diagnoses.
- Complete medication lists.
- Laboratory or imaging results.
- Social Security numbers.
- Insurance member or identification numbers.
- Payment-card information.
- Photographs of medical conditions.
-
Information you would not want transmitted through a general
website form.
What You Can Submit
For a general appointment request, you may provide your name, phone
number, email address, preferred contact method, whether you are a new
or existing patient, and a brief non-sensitive description of the type
of appointment you are seeking.
Review Required
Compare this list with the actual fields used in the website’s
appointment-request form before publishing this notice.
Secure Clinical Communication
If the practice needs medical records, detailed history, forms, or other
protected health information, the office will provide instructions for
an appropriate method of communication or secure system when available.
Information Required
Confirm the actual secure communication method patients will use,
such as the Patient Portal, secure forms, or another approved
clinical system.
Website Forms Are Not for Emergencies
Do not use the website, form, or ordinary email for emergencies or
urgent medical concerns. If you believe an emergency is occurring,
contact emergency services or go to the nearest emergency department.
Important Distinction
Use of a healthcare website does not automatically make every website
tool HIPAA-compliant. The practice will limit the public website form
to basic information and will use appropriate systems for sensitive
clinical information when required.
Compliance Review Required
Review this section after the final website forms, email delivery,
Patient Portal, analytics, hosting, and third-party integrations
are configured. The wording should reflect how sensitive clinical
information is actually handled by the practice.
