1. Collection of Information

By completing this form at the Compassion Pediatrics booth at Hillbilly Days, you voluntarily provide your name, email address, phone number (if given), and county of residence. This information is collected solely by Compassion Pediatrics & Behavioral Health Services, Pikeville, KY.

2. Use of Your Information

Your information may be used to: (a) contact you about our pediatric and behavioral health services; (b) send health tips and practice news; (c) inform you of upcoming events. We will never sell, trade, or share your personal information with third parties outside of Compassion Pediatrics & Behavioral Health Services.

3. Email Communications

By accepting these terms, you consent to receive email communications from Compassion Pediatrics. You may opt out at any time by contacting our office or clicking the unsubscribe link in any email we send you.

4. HIPAA Notice

This form does not collect protected health information (PHI). Submission of this form does not establish a patient-provider relationship. For information about your rights under HIPAA, please contact our office directly.

5. Data Security

We take reasonable steps to protect your personal information from unauthorized access, use, or disclosure. Your data is stored securely and accessible only to authorized Compassion Pediatrics staff.

6. Contact Us

Questions or removal requests: contact us at our Pikeville or Wayland office.