The law requires that ReEnvision Eyecare, PLLC make every effort to inform you of your rights related to your personal health information. By my signing below, I acknowledge that:

My vision plan requests that all diagnoses related to any medical condition I may have be released to them. As a non-traditional disclosure, release of this information requires my specific authorization:

Our office may use standard email to communicate with you. Standard email is not secure and does not guarantee privacy.