FAQs about GroupHab
ONLINE FITNESS CLASSES
I further acknowledge that the Practice can change it's HIPAA Privacy Notice in the future and that I can receive a copy of the Practice's current Privacy Notice at any time.
I understand that I have the right to request that the Practice restricts its uses and disclosures of my health information for treatment, payment or health care operations. If my restrictions are accepted by the Practice, these restrictions will be binding on the Practice. I also understand that the Practice is not required to agree to any restrictions.
By signing this form, I consent to the Practice's use and disclosure of my health information for treatment, payment, and health care operations. I understand that I have the right to revoke the consent at any time in writing, but if I do, my revocation will not affect any actions the Practice has already taken in reliance of this consent.
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