PATIENT FORMS
Save yourself some time by printing and completing these forms before your next eye exam appointment and bringing them in with you.
NEW MULTIFOCAL &
ACCOMMODATIVE LENS IMPLANTS
You can NOW enjoy the benefits of improving both near vision and far vision after cataract surgery! We offer our patients options for multifocal lens implants after cataract surgery to reduce dependence on glasses.
AFFORDABLE LASIK
Danbury Eye Physicians is proud to announce affordable LASIK eye surgery and patient financing options. If you are seeking LASIK in Connecticut call us today!
PEDIATRIC OPHTHALMOLOGY
Danbury Eye Physicians specializes in eye care matters related to children. In their own wing of the practice children are given special priority to help solve early vision problems such as amblyopia and strabismus.
Danbury Eye Physicians & Surgeons, P.C.
Notice of Privacy Practices for Protected Health Care Information
This Notice Describes How Medical Information About You May Be Used and Disclosed and How You Can Get Access To This Information. Please Review It Carefully.
Our goal is to take appropriate steps to attempt to safeguard any medical or other personal information that is provided to us. The Privacy Rule under the Health Insurance Portability and Accountability Act of 1996 (“HIPPA”) requires us to: (i) maintain the privacy of medical information provided to us; (ii) provide notice of our legal duties and privacy practices; and (iii) abide by the terms of our Notice of Privacy Practices currently in effect.
Who Will Follow The Notice
The notice describes the practices of our employees and staff as well as any individuals and/or business entities associated with Clay Eye Physicians. In addition, these individuals, entities, sites and locations may share Medical Information with each other for treatment, payment and health care operation purposed in the notice.
Information Collected About You
In the ordinary course of receiving treatment and health care services from us, you will be providing us with personal information such as:
Your name, address, and phone number.
Information relating to your medical history.
Your insurance information and coverage.
Information concerning your doctor, nurse or other medical providers.
In addition, we will gather certain medical information about you and will create a record of the care provided to you. Some information also may be provided to us by other individuals or organizations that are part of your “circle of care” – such as the referring physician and your other doctors, your health plan and close friends or family members.
We have available, upon your request, a copy of the Federal Guidelines and listing of all types of persons, entities, and/or situations in which we might disclose your personal health care information.