Acknowledgement and Consent
  • Welcome

  • Welcome

    As part of our commitment to quality and service, we request authorization to communicate regarding cases using the methods and communication channels selected and approved by our customers.

    While we offer secure messaging that meets all HIPPA requirements through our patient portal, we understand other convenient communication methods may be preferred.  Cottonwood Labs will communicate any way the customer requests, however, Cottonwood Labs does not gurantee other communication methods meet HIPPAA-requirements.

    By providing thia information, you ( the authorized representative) acknowledge and accept the potential privacy risks associated with non-secure communication methods and voluntarily reuest their use, if selected

  • Communication Method Options

  • Please approve communication methods*
  • If you selected WhatsApp, SMS, Email, or Zoom, how should we refer to cases?*
  • Acknowledgement and Consent*
  • Should be Empty: