Pediatric Orthopaedic Surgery Associates

Communication Authorization

POSA will communicate with you via the following methods:
  • Home telephone
  • Work telephone
  • Cellular telephone voice and text
  • Written communication to home address
  • Written communication via encrypted email
  • Written communication to fax number
You may discuss my health care needs with the following individual(s), i.e. stepparent, other family members, school, neighbors, nannies, etc. (do not include physicians):

Acknowledgement of Receipt of Notice of Privacy Practices (HIPAA)


I have been offered a copy of Pediatric Orthopaedic Surgery Associates' Notice of Privacy Practices

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