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Tell us about your vision needs and discuss your options with a specialist.
Tell us about your vision needs and discuss your options with a specialist.
PATIENTS ACKNOWLEDGMENT OF RECEIPT OF NOTICE
In accordance with the Health Insurance Portability and Accountability Act passed by Congress in 1996, Eye Surgical Associates, S.C. is required to supply each patient with a copy of its' privacy policies. We are required to maintain a signed receipt from you acknowledging the delivery of this document which will be maintained with your medical record.
I hereby acknowledge that I received the Eye Surgical Associates, S.C. Medical Information Privacy Notice for my review prior to receiving services through Eye Surgical Associates, S.C.
Eye Surgical Associates is the sole owner of the information collected on this site. We will not sell, share, or rent this information to others. We may send emails to our users announcing changes in our services or other information we believe will be of interest to our users. If you prefer not to receive email, you can send us an email with the subject line "no emails".
Notification of Changes
If we decide to change our privacy policy, we will post those changes on this page so our users are always aware of what information we collect. If at any point we decide to use personally identifiable information in a manner different from that stated at the time it was collected, we will notify users by way of an e-mail. Users will have a choice as to whether or not we use their information in this different manner. We will use information in accordance with the privacy policy under which the information was collected.
Contact us for more information or to schedule a complimentary consultation.