By initialing below, I acknowledge that I received a copy of Kenwood Hearing Centers’s Notice of Privacy Practices
. The Notice provides information about how Kenwood Hearing Centers may use and disclose the medical information that they maintain about me. Kenwood Hearing Centers encourages me to read the full Notice. I understand that a copy of the current Notice will be available in the office, the website (www.goodhearing.com
) and that any revised Notice of Privacy Practices will be made available.