Please read this note to users sending or requesting forms with private health information (PHI) via email.

Policy Information Regarding:

Policy Compliance with Assembly Bill 1278

  • Assembly Bill (AB) 1278 requires physicians to provide a notice to patients regarding the Open Payments database which is managed by the U.S. Centers for Medicare and Medicaid Services, or CMS.  The Open Payments database is a federal tool used to search for payments made by drug and device companies to physicians and teaching hospitals. The federal Physicians Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.

Medical Forms

Health Information Management (Medical Records)

Health Insurance/Billing Forms

Immunization Exemption Forms

For measles, mumps, varicella, meningococcal disease vaccines

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