Patient Information

• HIPPA Policy Form (Privacy Policy/Contact Authorization) - allows Advanced Cardiology to leave messages - call you on your cell phone - and contact you at work. Authorizes Advanced Cardiology to give information to designated family members.
   
• Notice of Privacy Policies for Advanced Cardiology, Inc.
   
• Insurance Coverage Assignment - This form authorizes Advanced Cardiology to be paid directly by your insurance carrier or Medicare.
   
• Patient Authorization to Use or Disclose Protected Health Information - This form is to be used if you want Advanced Cardiology to send your records to yourself, another doctor, facility, etc. Advanced Cardiology must have written permission from you to send your records.
   
• Authorization to Release Medical Records - This form authorizes Advanced Cardiology to get your records from another, doctor, facility, etc.