Notice Of Privacy Practices

Dilation of the Eyes

It will be necessary to dilate your pupils in order to perform a complete and thorough eye examination.

This allows the doctor to obtain a better view of the back of the eyes. The dilating drops typically last 3-4 hours. During this time you may find it difficult to focus at near and less commonly at distance.

You may be sensitive to light. You will be provided with post-dilation glasses.

We strongly recommend caution when driving or operating equipment or machinery after dilaton.

If you feel you would not be able to drive or return to work, we recommend Digital Retinal Photography and OCT in place of dilation.

Signing this section signifies that you have been informed of the risks and benefits of dilation.

Please select one of the options below, indicating your choice for Dilation:

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Acknowledgment Notice of Privacy Practices

Signing in this section signifies that you have received a copy of our Notice of Privacy Practices.

In the course of providing service to you, we create, receive and store health information that identifies you It is often necessary to use and disclose this health information in order to treat you, to obtain payment for these services, and to conduct healthcare operations involving our offices.

The Notice of Privacy Practices you have been given describes these uses and disclosures in detail.

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Digital Communication

I give permission to be in contact via text message or e-mail.

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