The following document details your information, your rights and our responsibilities as a primary care facility as required by the Health Insurance Portability and Accountability Act (HIPAA).  To view the document, please click on this link


The following document describes our policy regarding cancelling and missing appointments. To view the document, please click on this link

CANCELLATION POLICY


Assignment of Benefits

The following document is our consent to treat, assignment of benefits, and privacy form. To view the document, please click on this link


The document is our medical records release form to obtain records from other medical practice. To view and download this form, please click on this link

Medical records requests


The document is our medical records release form for Holtzman Medical Group to release your records to another practice. To view and download this form, please click on this link

medical records release