Policies & Forms

Authorization for Disclosure of Protected Health Information

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

New Patient Form

Please take some time to answer the questionnaire below to make your appointment more efficient and improve your overall experience.

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.

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.

Financial & Insurance

In our effort to provide you with exceptional care and service, we would like to make you aware of our financial policy.