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  1. Email Authorization & Registration

    Severna Park Medical Associates sends out announcements of closings and office changes. Our patients can now use email, rather than a phone call, to communicate non-urgent information with us. We can also send lab results and other information to patients directly.

    Please read, agree to the following authorization, and enter your information to register for email updates.

  1. Email Authorization Form

    Authorization to Utilize Unencrypted Email to Communicate Protected Health Information

    Thank you for your request to communicate with Severna Park Medical Associates via email. We want to make sure you know that email communications between us are not encrypted and therefore are not secure communications. If you elect to communicate with Severna Park Medical Associates from your workplace computer, you also should be aware that your employer and its agents may have access to email communications between us. Finally, email communications may become a part of your client medical record and be accessible to my clinical support staff as needed for our operations.

    Incoming email communications will be reviewed and responded to as soon as possible.

    If you have not heard from us with a response and are concerned we may not have received the message, please call the office during regular business hours.

    Email communication should never be used in the case of an emergency or for urgent requests for information.

    If you agree to the foregoing terms, please indicate that by checking the box below you accept the terms and conditions outlined herein.

    Please remember to update your email address with us if it changes.

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  1. Healthcare Provider:
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  2. Full Name:(*)
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  3. Date of Birth:(*)
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  4. Phone Number:(*)
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  5. Username:(*)
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  6. E-mail(*)
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  7. Password(*)
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  8. Confirm Password:(*)
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