Northwest Pediatric Opthalmology: Patient Information

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Patient Information

Privacy Policy

Our practice is committed to maintaining the privacy of your protected health information, while providing high quality care. In accordance with HIPPA regulations, you will receive a full written notice of our privacy practices at your first visit. This notice will explain in detail:

How we may use and disclose your information.
Your privacy rights regarding your information.
Our obligations concerning the use and disclosure of patient information.

It is important to be aware that, by regulation, we are allowed to use and disclose your information in order to provide and coordinate care. We are also allowed to use your information to bill your insurance company.

You, however, have the right to request restrictions on the use of your information. You may also request to inspect, copy, and amend your information.

Protecting your privacy is a priority. If you have a concern please feel free to contact our privacy officer for clarification or assistance.

Download Forms
Please download, print and complete the necessary forms and bring them to our office during your next appointment.

To view a .pdf or .doc file, you need to install the Adobe Acrobat Reader and/or Microsoft Word Viewer if you do not have an
application installed.

Download
Brochure

Appointments
We do our best to stay on time-though there are occasional, unavoidable delays. In order to help us stay on schedule, we ask our patients to be prompt. Please be aware, anyone arriving more than 15 minutes late will be asked to reschedule. New patients are asked to arrive 15 minutes prior to their appointment time for registration purposes. Anyone accompanying a child to their appointment other than a legal guardian must have a note authorizing them to give consent to medical treatment for that child. Washington State law requires this. Without written authorization, the appointment will have to be rescheduled.

Insurance and Referrals
Most insurance companies require referrals to access specialty care. It is your responsibility to arrange for a referral to see us. If a referral has not been received by appointment time your appointment will have to be rescheduled. Also, many insurance companies require a co-pay. Your co-pay is due at the time of service and is payable by cash or check only. We know more than anyone, how confusing the insurance process can be. In case of a dispute with your insurance company we will assist when possible. However, you are responsible for ensuring complete payment for medical services.