Legal & Policies

Policies & Patient Forms

Our practice policies, in plain language — covering privacy, billing, immunizations, and your rights as a PHCA patient family.

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Privacy Policy

How we collect, use and protect your family's information, including HIPAA-protected health records.

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No Surprises Act Policy

Your protections against unexpected medical bills, per the federal No Surprises Act.

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Non-Discrimination & Grievance Policy

Our commitment to non-discrimination, language access, accessibility, and how to file a grievance.

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Immunization Policy

Our approach to childhood immunizations, the CDC schedule, and catch-up plans.

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Divorced & Separated Families Policy

How we handle consent, communication and records access for separated or divorced parents.

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Financial Policy

Our billing practices — insurance, copayments, self-pay rates, and missed appointments.

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Printable Patient Forms

HIPAA Record Release Form Over-18 HIPAA Consent Form Authorization to Release Medical Record Information