Medical History Questionnaire
The questionnaire is designed to help your doctors know your general medical history and to save you time during your initial evaluation. Because the information is important for your health care, please fill it out carefully and completely. This will become part of your medical record; all information is strictly confidential. Please bring the completed medical history questionnaire with you to your first scheduled appointment.
PET CT Scan Patient Information
Please adhere carefully to these instructions on the day of the scan.
Authorization to Use/Disclose Protected Health Information
This authorization must be read, dated, and signed by the patient or by a person authorized by law to give authorization on behalf of the patient.
Insurance and Financial Policy
As cancer specialists, we are keenly aware that modern cancer care is often very expensive. We are sensitive to this fact and will work with you to provide the most effective treatment options while keeping an eye on costs. We see all patients referred to us for care. Our goal as physicians is to provide the best medical care for all of our patients. For more Insurance and billing information, click here. Please print, complete and bring the assignment of benefits and financial responsibilities form with you to your next appointment.
Patient Bill of Rights
A Patient's Bill of Rights is a statement of the rights to which patients are entitled as recipients of medical care which articulates that patients should be provided with information, offered fair treatment, and autonomy over medical decisions. Read it here.
Notice of Privacy Practices
Compass Oncology operates in compliance with the Health Insurance Portability and Accountability Act (HIPAA). HIPAA requires an increase in the security of patients’ health information.
Effective Date: September 01, 2013
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.