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williamsima.com · RECEIPT OF NOTICE OF PRIVACY PRACTICES WRITTEN ACKNOWLEDGEMENT FORM A copy of the HIPPA guidelines for the office of William Sima, M.D. was made available to me

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Page 1: williamsima.com · RECEIPT OF NOTICE OF PRIVACY PRACTICES WRITTEN ACKNOWLEDGEMENT FORM A copy of the HIPPA guidelines for the office of William Sima, M.D. was made available to me

Page 2: williamsima.com · RECEIPT OF NOTICE OF PRIVACY PRACTICES WRITTEN ACKNOWLEDGEMENT FORM A copy of the HIPPA guidelines for the office of William Sima, M.D. was made available to me

Page 3: williamsima.com · RECEIPT OF NOTICE OF PRIVACY PRACTICES WRITTEN ACKNOWLEDGEMENT FORM A copy of the HIPPA guidelines for the office of William Sima, M.D. was made available to me

Page 4: williamsima.com · RECEIPT OF NOTICE OF PRIVACY PRACTICES WRITTEN ACKNOWLEDGEMENT FORM A copy of the HIPPA guidelines for the office of William Sima, M.D. was made available to me

Page 5: williamsima.com · RECEIPT OF NOTICE OF PRIVACY PRACTICES WRITTEN ACKNOWLEDGEMENT FORM A copy of the HIPPA guidelines for the office of William Sima, M.D. was made available to me

Page 6: williamsima.com · RECEIPT OF NOTICE OF PRIVACY PRACTICES WRITTEN ACKNOWLEDGEMENT FORM A copy of the HIPPA guidelines for the office of William Sima, M.D. was made available to me

Page 7: williamsima.com · RECEIPT OF NOTICE OF PRIVACY PRACTICES WRITTEN ACKNOWLEDGEMENT FORM A copy of the HIPPA guidelines for the office of William Sima, M.D. was made available to me

Page 8: williamsima.com · RECEIPT OF NOTICE OF PRIVACY PRACTICES WRITTEN ACKNOWLEDGEMENT FORM A copy of the HIPPA guidelines for the office of William Sima, M.D. was made available to me

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