HIPAA & Privacy Standard
What intake involves, and why it stays secure.
Your health history deserves medical-grade security. We explain every intake section here so you know what to gather, while keeping all sensitive forms inside our verified clinical portal.
Security by design
Why we don't offer downloadable PDFs on the web
Paper health forms downloaded online encourage patients to email unencrypted medical records. At Palmer, intake is completed through our encrypted clinical system or right in our office.
The 7 Sections in Your Digital Intake
Each section gives Dr. Palmer the context needed to make your first conversation more useful.
- Section 01
Identity & Demographics
Legal name, date of birth, contact details, and emergency contact.
- Section 02
Guardian Authorization for Minors
Parent/guardian relationship and signed legal consent for pediatric visits.
- Section 03
Presenting Concern in Your Words
Where you feel discomfort, when it started, and what everyday motions it limits.
- Section 04
Medical & Musculoskeletal History
Past surgeries, chronic conditions, prescription medications, allergies, and prior imaging.
- Section 05
Insurance or Self-Pay Agreement
Payer information for benefit verification, or self-pay Good Faith Estimate election.
- Section 06
Access & Sensory Accommodations
Mobility assistance, interpreter needs, or sensory accommodations you request.
- Section 07
Legal & Privacy Acknowledgments
Notice of Privacy Practices, HIPAA consent, and transparent financial policy.
Next step / 01
Ready to begin?
Call our Jackson office at (517) 750-7790 to schedule, or log in directly to your patient portal.