acknowledge that I hove been given a copy of the Practice's *HIPAAPrivacyNotice" which describes the Practice's
obligations to ensure the privacy of my health information ... HIPAAPrivacyNotice also describes how the Practice may use
and disclose my health information for treatment, payment end health care operations. I know that I have the right ... review the
Practice's HIPAAPrivacyNotice and to ask questions about it. I understand the Practice Is required to maintain the privacy of
my health Information In accordance with