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.