This form reviews your financial responsibilities.
This notice reviews your Protected Health Information (PHI) rights and responsibilities.
Forms
Complete and bring these forms with you to your first appointment with Dr. Deutsch's office.
Use this form to have your medical records sent to Dr. Deutsch's office or to request that we forward your medical record outside our practice.
New To Medicare First Year Only: Medicare and Medicare Advantage Plans require this form be completed when you initially join Medicare.
Existing Medicare Patients: Medicare and Medicare Advantage Plans require this form be completed annually.
This form enables us to treat you through your Workers' Compensation claim.
This form enables us to communication your health care information to other individuals outside of medical care team.
This form enables us to treat you through your Auto Accident insurance benefits.