agreements and forms

Privacy Practices

On enrollment you will be asked to read and agree to our Privacy Practice Policy

Information and Records Release Consent Forms

Once a patient turns 18, we will give them a Release of Information form, that allows them to determine what information from the visit can be disclosed to parents.

Request for records from Dr. Bardsley or to Dr. Bardsley

Patient Agreement and Televisit Informed Consent

When enrolling in the practice, a patient agreement and a televisit informed consent is signed.

Monthly Billing Authorization

If the monthly-fee is chosen, an authorization for monthly billing is signed.