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By choosing to use e-mail to communicate with me and my medical practice, you understand and agree to be bound by the following.

1) I understand and and accept that the use of e-mail to transmit medical information poses certain risks to the confidentiality of all medical information sent. The use of the email, the internet, and the transference of data across the internet cannot provide a guarantee for the protection of confidential information.

2) I agree that I will not use e-mail to communicate with my physician about emergency matters. For any such matters, I understand that I will not relay such information through e-mail but will instead call 911 immediately.

3) I understand that there will be times when my physician or his staff will not have access to my e-mail because of technical issues, time of day, travel, or other reasons.

4) There can be no guarantee that this email is secure or free of errors, viruses, or other malware.

By checking the box below you agree to all terms above and will begin your email:



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