Forms and Policies
Email your completed and signed forms to the location of your appointment. For appointments at our Commonwealth Ave office, email to [email protected], for Roslindale send to [email protected]
- Acknowledgment of Privacy Practices & Consent to Treat Form
- Medical Records Release Form
- Email Authorization
- Medical Consent for Examination of a Minor
HIPAA Privacy Rule
The HIPAA Privacy Rule (Health Insurance Portability and Accountability Act of 1996) created national standards to help protect a patient’s personal health information (PHI) and medical records and how they are transmitted electronically. NECO Center for Eye Care adheres to a strict set of practices to protect your health information and comply with HIPAA Privacy Regulations. You may download a copy of our privacy practice above. You may also view our privacy statement.