Family Service Madison will need you to sign the HIPAA “Authorization to Use and Disclose Information” form. Please download the and read the authorization form. If you agree and acknowledge to the contents of this form, you can complete the consent to disclose form.
HIPAA Compliance Program
Family Service Madison has provided this Notice of Privacy Practices in compliance with HIPAA laws. This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.