The secure way to communicate with your Doctor
Disclaimer: it's a long story, but while Twistle is HIPAA-compliant, this form is not. Information submitted on this form is used to send you an invitation to the Twistle application. While we make every attempt to protect your privacy, we need to inform you that this form does not meet the inordinately complex requirements of HIPAA. By submitting this form, you authorize the transmission of this information to us. Alternatively, you can provide us this information, in person, when we see you in the office.