Patient Privacy Policy

This form, Notices of Privacy Practices, presents the information that federal law requires us to give our patients regarding our privacy practices. Please read the Notices of Privacy form online and then download the Acknowledgement of Receipt of the Notices of Privacy Practices form. Print a copy of the Acknowledgement of Receipt form, sign and date the form, and bring this form to our office on your first visit. This downloaded document will be placed in your medical record at our office verifying that you understand the federal government patient privacy policy. This will save time at your initial appointment.

Notices of Privacy Practices

Acknowledgement of Receipt of the Notices of Privacy Practices

For more information, or to schedule a consultation with Dr. Gregory Michaels, call our office in Lancaster, OH at Michaels Oral Surgery Phone Number 740-654-6628, or request an appointment online.