Our Patient Terms
Privacy Policy
Recognizing the importance of a patient’s privacy rights, Personal Physican/Doctors on Wheels Medical Clinic, APC maintains a comprehensive system of policies and procedures to help ensure that a patient’s privacy rights are protected. Because we are a direct-pay medical clinic, our privacy policy is simple. We do not share any of your information with anyone unless authorized by you in writing. We believe in the privileged nature of communications between physician and patient and that it is a safeguard for the patient’s personal privacy and constitutional rights. Policy exceptions which permit medical records release within applicable law: To another physician who is being consulted in connection with the treatment of the individual by the medical-care provider; In compelling circumstances affecting the health and safety of an individual; Pursuant to a court order or statute that requires the physician to report specific diagnoses to a public health authority; and Pursuant to a court order or statute that requires the release of the medical record to a law enforcement agency or other legal authority.
Financial Responsibility
I authorize Personal Physican/Doctors on Wheels Medical Clinic, APC. to administer medical care including physical examinations, diagnostic tests and minor surgical outpatient medical treatment, as necessary for the medical treatment of conditions diagnosed to be performed by physicians, and/or nurse practitioners and staff. I agree to be financially responsible for all medical charges and services rendered. I understand that Personal Physician/Doctors on Wheels is a direct-pay medical clinic and that I am fully responsible for all medical charges. I understand that Personal Physican/Doctors on Wheels Medical Clinic, APC will not be held accountable for the amount that my insurance deems reimbursable if I seek reimbursement from my insurance. I have received and agree to the terms and conditions set by Personal Physician/Doctors on Wheels Medical Clinic, APC Financial Policy. I hereby authorize and direct that a copy of this authorization be accepted in place of the original and effective the date signed until revoked in writing.