Fwd: HIPAA Forms
Jeremiah Sturgill
Dr. Sturgill
__
Jeremiah Sturgill, DMD, MPH, DHEd
1206 Willow Lawn Drive
Richmond, VA 23226
From: Rhonda Legge <Rho...@americanboardortho.com>
Date: Mon, Feb 16, 2015 at 12:46 PM
Subject: HIPAA Forms
To: Jeremiah Sturgill <jws...@gmail.com>
Dear Dr. Sturgill:
You do not need to provide us with the HIPAA forms as you already attested to their existence during the registration process. It is the Ortho Program's responsibility to keep the forms on file. Your confirmation of their existence is all that we require.
Kind regards,
Rhonda Legge, Written Exam Coordinator
American Board of Orthodontics
401 North Lindbergh Blvd., Suite 300, St. Louis, MO 63141
●P: 314.432.6130 ●F: 314.432.8170 ●rho...@americanboardortho.com
Search for a board certified orthodontist here:
From: Jeremiah Sturgill [mailto:jws...@gmail.com]
Sent: Monday, February 16, 2015 11:38 AM
To: Rhonda Legge
Subject: Re: Proof of Treatment Affidavit received
Great, thank you!
Also, where/how do we submit the HIPPA release our ABO patients sign? Thanks!
Dr. Sturgill
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Jeremiah Sturgill, DMD, MPH, DHEd
1206 Willow Lawn Drive
Richmond, VA 23226
On Mon, Feb 16, 2015 at 12:35 PM, Rhonda Legge <Rho...@americanboardortho.com> wrote:
Please consider this confirmation that your Proof of Treatment affidavit was received and placed in your file.
Kind regards,
Rhonda Legge, Written Exam Coordinator
American Board of Orthodontics
401 North Lindbergh Blvd., Suite 300, St. Louis, MO 63141
●P: 314.432.6130 ●F: 314.432.8170 ●rho...@americanboardortho.com
Search for a board certified orthodontist here:
From: Jenifer Vetter [mailto:jve...@atsu.edu]
Sent: Monday, February 16, 2015 10:48 AM
To: Rhonda Legge
Cc: Jae Park; Jeremiah Sturgill
Subject: ABO Certification form for Dr. Jeremiah Sturgill
Dear Rhonda,
I have attached Dr. Jeremiah Sturgill's ABO certification form from Dr. Park. If you have any questions, I can be reached at 480-248-8115.
Sincerely,
Jen
Jenifer Vetter, B.S.
Program Manager, Orthodontics
A.T. Still University
ASDOH, Postgraduate Orthodontics
5835 E. Still Circle
Mesa, AZ 85206
Tel: 480-248-8115
Fax: 480-248-8117
