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Notice of Privacy Practices Acknowledgement Form Tamales Internal Medicine 23 Reed Blvd., Ste 120 Mill Valley, CA 94941 I understand that, under the Health Insurance Portability & Accountability Act
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Tamalpais Internal Medicine is a medical practice that provides comprehensive healthcare services.
Patients who receive medical services from Tamalpais Internal Medicine are required to have their information filed.
To fill out Tamalpais Internal Medicine, patients must provide their personal and medical history information accurately.
The purpose of Tamalpais Internal Medicine is to maintain medical records of patients and provide quality healthcare services.
Information such as patient demographics, medical history, medications, allergies, and treatment plans must be reported on Tamalpais Internal Medicine.
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