Emily Hudson, ND

5 S. Newstead Ave. St. Louis, MO 63108

hello@emilyhudson.com

(314) 626-0271


CONFIDENTIALITY AGREEMENT

Naturopathic Doctors adhere to the current standards of privacy as outlined by HIPAA (The Health Insurance Portability and Accountability Act of 1996). Emily Hudson keeps any and all client information confidential. We believe that all client cases and concerns are never discussed or disclosed to any parties and this information is considered private therefore, we will never share any of your details without your consent. Clients have a right to disclose their medical information with whomever they so choose. We will not discuss your health with any other person unless provided with written consent from you. Clients who are minors or those with a legal representative are exempt from this requirement.

I understand that this is a formal, legal agreement and if either party should violate this agreement, legal action may be taken.

Client Name: (Please print):

Client or Guardian Signature:

Date:

Signature of clinician:

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