CEDAR HILL
REQUIRED |
|
Consent Policy // For patients getting eye examinations and/or requesting services be rendered.
Retinal Screening // Our office offers the best technology available because we believe that our patients deserve more than the bare minimum standard of care. Please review this form to obtain more detail regarding our screening technology.
Medical History Form (Electronic) // For patients looking to fast-track their examination time, medical histories may be submitted electronically!
REQUIRED FOR CONTACT LENS EXAMS AND/OR MATERIALS |
|
Contact Lens Policy // For patients getting contact lens fittings/examinations and/or patients interested in purchasing boxes of contacts
MISC. FORMS |
|
PLEASE REVIEW & FILL OUT ANY FORMSAS DIRECTED BY OUR STAFF, OR AS APPLICABLE TO YOUR INDIVIDUAL NEEDS/SITUATION.
|
Medicare Beneficiary Notice // For patients using Medicare insurance
Email Authorization Form // For patients looking to receive protected health information (e.g. glasses/contacts prescriptions) through unencrypted email.
Release of Medical Information // For patients looking to send their records to their optical, primary care physician, or other healthcare professional.
PRIVACY & CONFIDENTIALITY |
|
Our office is committed to maintaining the confidentiality of our patients' medical information. As obligated by law, our practice also makes every effort to provide notice of our privacy practices. These policies can be found below for your convenience.
HAVE A QUESTION, COMMENT, OR CONCERN? |
|
Please review our Frequently Asked Questions!