Last updated July 31, 2026
Professional inquiries only
The website contact form is intended for physicians, clinic representatives, attorneys, and other professional business inquiries. It is not a patient portal and is not intended for patient care, referrals containing patient details, or the transmission of protected health information.
Do not include patient names, dates of birth, medical records, claim numbers, diagnostic details, insurance identifiers, or other information that could identify a patient. Contact Dr. Croxford directly to arrange an appropriate method for providing case-related records.
Information collected
The contact form requests your name, professional role, organization, email address, clinic location, inquiry type, and message. A telephone number is optional.
How information is used
Inquiry information is used to respond to your message, evaluate clinic coverage, discuss scheduling, and maintain ordinary business correspondence. Submitting the form does not create a clinician-patient relationship or guarantee service availability.
Form delivery service
Form submissions are processed by FormSubmit and delivered to Dr. Croxford by email. FormSubmit may process the submitted information as necessary to provide that service. Review the FormSubmit privacy terms for additional information.
Security and retention
No website or email transmission can be guaranteed completely secure. For that reason, sensitive patient or medical information should never be sent through this form. Professional inquiry information may be retained as part of ordinary business correspondence.
Questions or requests
For questions about this notice or a professional inquiry you previously submitted, contact Dr. Croxford at drcroxford@drcroxford.com or 779-348-9886.