The Great EyeDeal
HOME | CART | MY ACCOUNT | PRODUCT SEARCH
  Eyedeal Catalog
Patient FormsPatient Forms
File JacketsFile Jackets
Custom ProductsCustom Products
Custom Rx FormsCustom Rx Forms
Business CardsBusiness Cards
  My Account
My ProfileMy Profile
Order HistoryOrder History
  Testimonials
"For many years as Vice President of Professional Services at Cole Vision, I partnered with the good folks at Great Eyedeal to provide our affiliated ...."  more
- Michael L. Cohen
O.D., F.A.A.O.
  Order Forms
To download and print an Order Form or to request information on Promotional Items, please click here
About Us Shop Now! Specials Help
 
  HIPAA Access to Records Form


PF923318
Manufactured By: USFI
These forms meet all the requirements set forth by the Health Insurance Portability and Accountability Act (HIPAA). According to the HIPAA certification we are compliant with the requirements relating to privacy, confidentiality and security of individually identifiable health information.
Packaging: 50 per pad
Retail Price: $3.60
Your Price: $2.50
Qty:

Great Eye Deal Please call 1-888-480-4835 ext. 145 between 8:00 AM and 5:00 PM CST. Mon. - Fri.
Voice mail available. All calls returned within 2 hours or less.
customercare@greateyedeal.com : www.greateyedeal.com : 1-800-422-2903 (fax)
Great Eyedeal 12100 Ford Road, Suite 100, Dallas, TX 75234