Patient Privacy Forms

This Patient Privacy Form (on the bottom of Patient Health History Form) acknowledges that you have read and understand the Notice of Health Information/Privacy Practices of Pittsburgh Foot and Hand Center regarding possible use or disclosure of your medical information.  You may also determine who may receive information about your health care. Please print the form out, sign it and bring/mail this to our office or send it to us through your secure Patient Portal two days prior to your office visit.

  1. Patient Privacy Policy
  2. Notice of Health Information/Privacy Practices