Desert Kidney Associates, PLC
612 W Baseline Rd., Mesa, AZ 85210
Phone 480-834-9039 Fax 480-964-7802

Acknowledgement of Receipt of Privacy Practices and Health Information Practices



,    

have received a copy of this Office's Notice of Privacy Practices and Health Information Practices.

   
 
(Electronically Signed)
   

For Office Use Only


We attempted to obtain written acknowledgement of our Notice of Privacy Practices and Health Information Practice Acknowledgement could not be obtained for reasons stated below:



Revised 3/29/16