HIPAA Consent
Although this form is dual encrypted using SSL & PGP, there is the slight possibility that this communication can be intercepted in transmission, decrypted, or misdirected. Your use of email to communicate protected health information to us indicates that you acknowledge and accept the possible risks associated with such communication. If you do not wish to have your information sent by email, please call us with the information at (212) 366-4450 or you can download this form and fax it to (855) 486-2314.