As a result of the Health Insurance Portability and Accountability Act (HIPAA), enforced by the US Department of Health and Human Services offices of Civil Rights, we are not permitted to release patient information except as stated in the Notice of Privacy Practices, or in accordance with your wishes, as stated below.
This waiver authorizes Flora Levin, MD to send or receive my medical information as noted:
I may wish to communicate with Dr. Levin by email or SMS text messaging regarding various aspects of my medical care. I am aware that text and email are not HIPAA compliant methods of communication. I understand that this means my privacy cannot be fully protected or guaranteed using these methods of communication. Understanding this, should I choose to communicate with Dr. Levin by text or email either before, during, or after my care with her, I give Dr. Levin permission to respond with text or email in return.