6010 Pointe West Boulevard, Bradenton, FL 34209
Phone:(941) 746-2711 Fax:(941) 746-3433
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The Demographic Sheet contains important information about you. Please fill it out completely and bring it to your initial office visit.
The Notice of Privacy Practices is required by the Privacy Regulations stemming from the Health Insurance Portability and Accountability Act of 1996 (HIPAA). THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
The Financial Policy is a statement about billing responsibilities. It is also an authorization to provide your insurance company with information in order to process your claims. Please review and sign this document for your first appointment.
The Release of Information form allows Bach and Godofsky Infectious Diseases to obtain or release private health information. This signed form can be sent via fax to (941)746-3433 or brought directly to the office.
Release of Information Form
Patient History: Please access the patient portal to fill out online. This will decrease the pre-visit time in the office.
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