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HIPAA Agreement
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To protect yourself and the information of your patients, please sign this HIPAA agreement with VT-Med.
Once you complete the below steps you’ll be covered. Instructions:
1 – Download the HIPAA agreement. (Download)
2 – Print a copy of the document.
3 – In this area write the name in which your clinic is registered.
 4 – Sign your name here:
 5 – Write your printed name here:
 6 – Write the current date here:
 7 – Fax it to: 1-(800)-976-8803
8 – Keep the copy in a safe place.
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