Patient Forms
Please complete the Medical History Form and bring it with you to your eye exam. This will help our doctors to get to know you better. You can download the Medical History Form by clicking on the underlined link below
| Medical History Form |
| Notice of Privacy Practices |
Dear Patients:
The Notice of Privacy Practices describes how your medical information may be used and disclosed, and how you can obtain access to this information. Please review it carefully.
We respect our legal obligation to keep health information, that identifies you, private. The law obligates us to give you notice of our privacy practices.
As a patient, you have the right to adequate notice of the uses and disclosures of your protected health information. Under the Health Insurance Portability and Accessibility Act (HIPAA), Almaden Family Optometric Center can use your protected health information for treatment, payment and healthcare operations.
For further information, please open the attached document by clicking on the underlined link above, and/or contact Drs. Linda Yee, Curtis W. Keswick or Dr. Jennifer Hsieh, O.D.
-Your Friendly Optometrists and Staff at
Almaden Family Optometric Center
The Notice of Privacy Practices describes how your medical information may be used and disclosed, and how you can obtain access to this information. Please review it carefully.
We respect our legal obligation to keep health information, that identifies you, private. The law obligates us to give you notice of our privacy practices.
As a patient, you have the right to adequate notice of the uses and disclosures of your protected health information. Under the Health Insurance Portability and Accessibility Act (HIPAA), Almaden Family Optometric Center can use your protected health information for treatment, payment and healthcare operations.
For further information, please open the attached document by clicking on the underlined link above, and/or contact Drs. Linda Yee, Curtis W. Keswick or Dr. Jennifer Hsieh, O.D.
-Your Friendly Optometrists and Staff at
Almaden Family Optometric Center
