SSC Ticket Submission The minimum necessary standard imposed under HIPAA requires covered entities to share the minimum necessary information with their business associates. Please include in this form the minimum necessary information for us to help answer your questions. Information such as name, date of birth, address of your patients or clients is not necessary and should not be included.Clinic Name* Email* Are you a new Clinic? Yes No Are you a new Coach? Yes No Subject IssueStart Weight (in pounds)Current Weight (in pounds)Height (in feet e.g. 5'9) AgeSex Male Female Number of Weeks on ProtocolRegular or Alternative Protocol Regular Alternative Number of Packets Per DayPlease enter a number from 0 to 15.Medication(s) and DosageMedicationsMedicationDosage Click the + symbol to add additional medications.Attachment Drop files here or Select files Max. file size: 4 MB.