REQUIRED PATIENT DOCUMENTS

All patients must acknowledge receipt of Active Life's HIPAA (privacy) policy.  Medicare beneficiaries also will be acknowledging receipt of current Medicare Supplier Standards.  Both documents are available as a viewable or downloadable PDF, and you may request a paper copy to be mailed to you.  Please contact our TeleHealth care team at TeleHealth@4activelife.com if you have any questions regarding completion of these forms.
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PATIENT ACKNOWLEDGEMENT (E-SIGNATURE)