Home
Medical Team
Services
Patient Info
Dialysis Facilities
Contact Info
Patient Education
Glossary

Employees

 E-mail This

Michigan Kidney Consultants, PC
Notice of Privacy Practices Acknowledgement

Federal law requires that we offer you a copy of our Notice of Privacy Practices and document that we did so. If you would like a copy, simply tell our receptionist.

I acknowledge that I have been offered a copy of the Michigan Kidney Consultants Notice of Privacy Practices.

PLEASE SIGN HERE:

---

Signature

If you wish to authorize us to release medical information about you to any friends or relatives, please list them below.

Name	Relationship
__________________________________	__________________________________
__________________________________	__________________________________
__________________________________	__________________________________

Is it OK to call you at work? Circle one: YES / NO

Is it OK to leave a short message on your home or work voice mail? Circle one: YES / NO

Feature Sample:
Filmmaking at the beginning of the twentieth century was in it's infancy. The techniques at that time could only show people and objects as they were, with an occasional photographic trick. As technology progressed, so did the effects we see on film. We no longer find it amazing that a star ship can appear to rush through space at "warp speed". We see whole cities demolished, knowing they are truly intact, and accept this as the norm. So to envision people flocking to a theater to see a movie that was entirely silent is a bit incredulous to us now. But that was the reality of the early twentieth century.