Disclaimer
Federal and state laws and regulations protect the privacy of "individually identifiable health information". Such information or data relates to an individual's past, present or future physical or mental health, provision of health care, or payments for health care services, and that identifies an individual or can reasonably be used to identify an individual. Information that identifies an individual includes, among other things, common identifiers such as name, address, date of birth, social security number, telephone number, and similar information. By checking the box below, you acknowledge and agree that this communication platform is not guaranteed to be secure for purposes of applicable privacy laws and regulations, and you will not enter any information when using this system that can be considered individually identifiable health information.