Patient Forms Available For Download
You may access the following forms to assist us with your care. Please print and fill out the following forms, then bring them to your appointment.
PATIENT REGISTRATION
MEDICAL HISTORY
RECORDS RELEASE
HIPAA POLICY
Cataract Lifestyle Questionnaire
Notice of Privacy Practice
MEDICAL HISTORY
RECORDS RELEASE
HIPAA POLICY
Cataract Lifestyle Questionnaire
Notice of Privacy Practice
Our Promise Of Privacy And Consent To Patient Records
Our office is fully committed to compliance with HIPAA guidelines by:
1. Providing appropriate security for our patient records.
2. Protecting the privacy of our patient’s medical information.
3. Providing our patients with proper access to their medical records
4. Appropriately maintaining our patient information and billing processes in compliance with national standards.
If you ever have any questions or concerns about your services or charges, we encourage you to call and ask for our Compliance Officer.