In 1996, the U.S. Congress passed The Health Insurance Portability and Accountability Act (“HIPAA”) to protect the privacy of patient health information. HIPAA prohibits health care providers from releasing patient health care information unless the patient has signed a HIPAA release form. By checking the box yes herein, you certify that you have obtained a signed release form from the patient for whom you are requesting a LifetimeAnalysis™.

Click here to print a HIPPA Release Form.