Telehealth Prescription Upload
Disclaimer:
This form is to be used only for the purposes of sending patient prescription data, in accordance with the Indiana Eye Doctors HIPAA agreement found here [https://www.indianaeyedocs.com/pubfiles/Indiana%20Eye%20Doctors%20Privacy%20notices.pdf]. Any information received will be securely stored, and the data not shared with any party outside of the Indiana Eye Doctors organization without the Patient's consent.
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