Patient AcknowledgmentConcierge Services EnrollmentAdministration FeeInstructions for TreadmillInstructions for Stress TestNotice of Privacy Practice
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Patient Name:
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HIPAA -- Notice of Privacy Practices
I have been provided with a copy of CVMG Joint Notice of Privacy Practices.
I know that the Notice may be changed at any time.
I may get a new copy of the Notice on the CVMG website or by writing to the Cardiovascular Medical Group, 414 N. Camden Drive, Suite 1100, Beverly Hills, CA 90210
Patient Signature:
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Date/Time:
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