Notice of Privacy Practices Acknowledgment Posted on June 10, 2026 by PDX ENT Notice of Privacy Practices Acknowledgment PDX ENT & Audiology Medical Group Notice of Privacy Practices Agreement(Required) By signing below, I agree that I have been offered a copy of the notice of privacy practices Patient/Parent/Guardian Signature(Required) Minor’s Legal Guardian Printed Name(Required) First Name(Required) Last Name(Required) Email(Required) Date(Required)