919 Fifth Avenue, Suite 100
Huntington, West Virginia 25701
(304) 523-4819

 

 

 

Just when you thought you had seen enough medical forms to fill a lifetime, the federal government comes up with another batch under new provisions of the Health Insurance Portability and Accountability Act (HIPAA).

Now in effect, these new privacy regulations apply to health information kept by medical offices that engage in certain electronic transactions, health plans and health care clearinghouses. The U.S. Department of Health and Human Services has issued regulations requiring anyone with access to individually identifiable health information to take steps toprotect confidentiality.

What's that mean to you?

Several new forms must be read and signed, not just at our facilities but in all doctors' offices you visit. In other words, for our current and new patients alike, there will be some new paperwork before seeing the doctor on your next visit.

Fortunately, through this Web site, you can at least get that business out of the waybefore your appointment. Use your computer to read these files online, print them out, sign them and then simply bring them with you when you come to see us. To do this, just follow these two steps:

  • Step 1: Read the new three-page Notice of Privacy Practices statement by clicking here. This calls up the three-page federal statement in the Adobe Acrobat Reader. When you finish, click your browser's Back button to return to this screen and continue with Step 2. (Note: If nothing happens when you click the link or if you get an error message, chances are you don't have the Acrobat program on your computer or you have an outdated version. Click here to get the latest Acrobat for free.)

  • Step 2: After you have read the notice in Step 1, you need to read and sign the one-page Receipt of Notice of Privacy Policies & Consent Form. Click here to display the form on your screen, again the Acrobat software. Once it is displayed, click Acrobat's File option on the menu bar and select Print from the drop-down menu to print it out. Read and sign the printout, then click your browser's Back button to come back to this page.

Fax Your Forms

And by the way, if you'd rather not have to remember to bring the completed forms with you for your appointment, you can fax them to us ahead of time. Our fax number is
(304) 525-5551.

 

New Patients - More Forms

If you're a first-time patient, we have other forms for you to fill out at the office. Or you can get a jump on the procedure by printing them out here. Just click on a form below. We'll open it into a separate window and give you an opportunity to print it out. Then just fill out the paper copy and bring it with you when you come for your appointment. (Note: If nothing happens when you click the link or if you get an error message, chances are you don't have the Acrobat program on your computer or you have an outdated version. Click here to get the latest Acrobat for free.)

Home | News & Links | Our Services | About Us | Our Forms | Corneal Refractive Therapy | LASIK Eye Treatment | Sunglasses