Acknowledgement of Privacy Notice Form

The Acknowledgement of Receipt of Privacy Notice Form (Privacy Practices Form) is required for new patient registration.  It is a government-required form.  To complete this form, please click the link below:

 

https://cryptnsend.com/stfh/stfh.html

 

The form above refers to the below notice:

View our Notice of Privacy Practices

 

If you prefer a downloadable pdf version of this form, please go to the Forms page

827 S Magnolia Blvd Suite 6

Magnolia, TX 77355

281-259-7400

Office of:

Paul Dibble MD

Pamela Johnson MD

We will be closed 11/28/2019 (Thu) in observance of Thanksgiving. 

 

We are open our other hours as usual, including 11/29 (Fri) and 11/30 (Sat)

Print Print | Sitemap Recommend this page Recommend this page
© Simple Traditions Family Health PLLC

This website was created using 1&1 IONOS MyWebsite.