New Patient Information



Authorization for Disclosure of Protected Health Information

Complete this form to authorize the use or disclosure of medical records and other related health information.

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HIPAA-Patient Acknowledgement Form

Our notice of Privacy Practices (NPP) provides information about how long Lourdes Cardiology Services, PC may use and disclose protected health information (PHI) about you. The practice provides this form to comply with the Health Insurance Portability and Accountability Act (HIPAA).

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New Patient Form

Welcome to our practice! Our doctors and staff are here to serve you, and look forward to a productive and healthy relationship. Please take some time to answer the questionnaire below to make your appointment more efficient and improve your overall experience.

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Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. 

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