Derek A. Campbell, Ph.D.

Clinical Neuropsychologist


NOTICE OF PRIVACY PRACTICES

CNS HIPAA Privacy Practice Form





Campbell Neuropsychological

Services, P.C.

forms                             

release of information forms                    

Authorization Form to Release Records TO Dr. Campbell


Authorization Form to Release Records FROM Dr. Campbell


Authorization Form to Release Test Data FROM Dr. Campbell*

     *Iowa law requires that test data be released only to Licensed Clinical Psychologists