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MEDICAL RELEASE FORM

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ACKNOWLEDGEMENT OF PRIVACY PRACTICES

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HIPAA PRIVACY NOTICE BRIEF

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PATIENT

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Office policies for patients of the Georgia Vision Institute, providing state-of-the-art, high quality vision care for patients.

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705 Dallas Highway Suite 103

Villa Rica, GA, 30180

     770-459-2022


     404-256-2006

Villa Rica

158 Clinic Avenue
Carrollton, GA, 30117

    770-834-1008


    770-834-2531

Carrollton

300 Alabama Ave
Bremen, GA 30110

     678-821-1880

Bremen

Georgia Vision Institute & Georgia Cataract & Eye Specialty Center

By Lime Biscuit Creative For Georgia Vision Institute