Open/Close Menu Miller Prosthetics & Orthotics

Call: 740-421-4211
Fax: 888-972-5171

Skip to content
  • Home
  • About Us
    • Brochure
    • News
      • In the News!
      • Press Releases
    • Capabilities Statement
    • Technology
    • Vision – Mission – Values
  • Services
    • Prosthetics
    • Orthotics
      • Foot Orthotics
    • Cranial Remolding Helmets – STARbands
    • Education
      • Early Detection and Intervention for Cranial Deformation in Infants
        • Resource Material: Cranial Remolding Orthoses
      • Guidelines for Pediatric Orthotic Identification, Selection, Fabrication, Use, and Care
    • First Swing – Learn to Golf
    • Get Active & Get Informed!
    • Prosthetic Users Group – www.PugMov.com
      • Survey for Prosthetic Users Group Meeting
      • 2017 Amputee Coalition National Conference
      • Amputee Coalition National Conference June 2016
  • Directions
  • Inspiring Stories
    • Inspiring Stories
    • Keating, Therapy Dog
    • Keating Was Here Gallery
    • Paralympics
  • Patients
    • Amputee Resource Guide
    • How to Videos for Amputees
    • Limb Loss Awareness Poster
    • Patient Forms
      • New Patient Packet
      • Patient Information Form
      • Medical History Form
      • Prosthetic Medical History
      • Medicare Supplier Standards
      • Notice of Privacy Practices
      • Privacy Consent for Caregivers
      • Protected Health Information – Consent Form
      • Protocol for Resolving Complaints from Medicare Beneficiaries
      • Release and Consent Form
    • WV Amputee Fact Sheet
  • Physicians
    • Physician’s Order and Notes
    • Same or Similar – Medicare
  • Shop
  • The Amputee Center

Protected Health Information – Consent Form

ConsentDisclosureofHealthInfo

© 2023 - Miller Prosthetics & Orthotics, LLC

↑

Call Toll Free     1-800-972-5171