HIPAA PRIVACY
I understand that the Eye Center of Houston may use and disclose necessary personal health information (for example, my name, address, subscriber identification number, eye exam information, and/or type of products provided) to another party to permit to perform its administrative duties, provide me with eye care services and products, process my medical and/or vision benefit claims and communicate with me regarding medical/vision care services provided. I can be assured that this location does not sell my personal health information of any kind to a third party for such party's own use. I authorize to submit my medical/vision benefit claims to my plan sponsor or health plan to receive reimbursement directly for the medical/vision services and products that I have received.