NOTICE OF PRIVACY PRACTICES

To comply with federal regulations (HIPAA), this office has established procedures to make your identity and medical records more secure. Our only use of your personal information is for billing purposes and for proper medical and ocular treatment. We must have on record, a signed acknowledgement, that you have read your rights and responsibilities as patients and that you understand them. Please contact the office staff if you have any questions.

PATIENTS RIGHTS

*To receive service within a reasonable period of time.

*To receive medically necessary services.

*To be treated with respect and courtesy.

*To receive all available information about your care and treatment, including risks and options.

*To have your medical coverage explained to you.

*To have all medical and personal records treated as confidential.

*To participate in treatment decisions.

*To refuse treatment.

*To receive impartial access to treatment.

*To receive a second opinion regarding any treatment plan.

*To review or to receive a copy of your medical record subject to legal restrictions and reasonable copying charges.

*To request review of your records by the doctor, and to request corrections if necessary.

*To be given information on how to file a complaint/grievance.

*To formulate an advance directive if you have a life threatening illness or injury.

PATIENTS RESPONSIBILITIES

*Having appropriate identification, insurance membership cards, coverage stickers, etc., at the time of the appointment.

*Keeping appointments or contacting this office in advance to cancel an appointment.

*Fulfilling financial obligations at the time of service such as deductible or co-pay fees.

*Providing complete and accurate information.