Draft for pre-launch review · July 14, 2026
Information you choose to provide
General inquiries may include name, contact information, preferred contact method, ZIP code, inquiry category and message. Do not submit medical records, diagnoses, Social Security numbers, insurance identifiers, payment information or other sensitive data.
How information may be used
Information may be used to respond, evaluate service availability, communicate next steps, maintain records, protect the website and comply with applicable obligations.
Website and technical information
Hosting and security providers may process IP address, browser type, device information, referring page, requested pages and security events. Any analytics, cookies or tracking must be inventoried and disclosed before activation.
Sharing and service providers
Information may be shared with authorized personnel and providers supporting business operations, subject to appropriate responsibilities, or when required by law.
Retention and security
Information should be retained only as long as reasonably necessary. No online system guarantees absolute security. Use a secure intake method if sensitive information is required later.
Health information
Whether an interaction is subject to HIPAA or another requirement depends on the parties, information and activity. These forms are intentionally designed not to collect protected health information.