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.