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HIPAA Related Information
Electronic Communication
(e-mail) Consent Form:
Many patients and their physicians have indicated their willingness
and desire to use electronic technology, such as e-mail, to
communicate with one another regarding aspects of their health
care that is not medically urgent. Because of CapitalCare's
concern about the confidentiality of your personal health
information, as well as increased awareness of privacy matters
due to the Health Insurance Portability and Accountability
Act of 1996 (HIPAA), it is our policy to obtain patient consent
before using electronic mail (e-mail) to communicate with
our patients. If you wish to use e-mail to communicate with
your CapitalCare physician, please read the e-mail
consent form carefully. This form describes potential
problems that can occur with e-mail communication that are
beyond CapitalCare's control. If you accept the terms
of the consent form, you may print the form, sign it and mail
it to your CapitalCare physician.
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Notice of Privacy Practices:
The effective date for the Privacy Regulations of the Health
Insurance Portability and Accountability Act of 1996 (HIPAA)
is April 14, 2003. HIPAA requires CapitalCare to
post our Notice of Privacy Practices on our website, and in
our offices. In addition, a written copy of the Notice is
available to our patients upon request. Because of our concern
about the confidentiality of our patients' personal health
information, we ask you to acknowledge that you have received
this privacy information. If you wish, you may print the first
page of the privacy
notice, sign it and bring it with you to your next appointment.
If you prefer, our office staff will present you with a paper
copy and ask you to acknowledge receipt of this information
at the time of your next visit.
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Medical FAQs