Patient Forms

Effective Date: October 1, 2025

ReFocus (“we,” “our,” or “us”), a HIPAA covered entity, respects your privacy and is committed to protecting the personal information you share with us in compliance with the HIPAA Privacy and Security Rules, as well as applicable state laws in New York, New Jersey, Connecticut, Massachusetts, Pennsylvania, Rhode Island, Virginia, Delaware, and Maryland. This Privacy Policy explains how we collect, use, disclose, and protect your information when you visit our websites or interact with us online, including anonymized data collection practices.

Information We Collect: We may collect personal information (name, email, phone), non-personal data (browser type, IP address, analytics), and limited health-related details if you submit them through our forms. Any Protected Health Information (PHI) submitted is used solely for responding to your inquiries, anonymized where possible, and handled in a manner consistent with HIPAA regulations, including encryption in transit and at rest via SSL/TLS. No marketing trackers are used on the site.

How We Use Information: To respond to requests, schedule appointments, improve services and site performance, communicate updates (with consent where required), and comply with legal obligations such as HIPAA risk assessments and state privacy laws. We retain personal information for as long as necessary for these purposes, generally 6 years for PHI under HIPAA standards.

Sharing: We do not sell or rent personal information. We may share information with service providers who support our operations (e.g., hosting, analytics, communications) under confidentiality obligations and executed Business Associate Agreements (BAAs) as required by HIPAA. Sharing occurs only with authorities when required by law, and all data is anonymized to the extent feasible.

Security: As a covered entity, we use reasonable administrative, technical, and physical safeguards including SSL/TLS encryption for PHI, multi-factor authentication where applicable, and annual risk analyses to protect information per the HIPAA Security Rule updates effective 2025. In the event of a breach, we will notify affected individuals within 60 days (or 30 days per updated rules if applicable) as required by HITECH. No method of transmission or storage is 100% secure; we cannot guarantee absolute security.

Your Choices: You may request access, correction, or deletion of your personal information by contacting:
Director of Quality, Safety, and Compliance
Rabia Hamid – rabia.hamid@refocuseye.com. We will respond within 30 days under HIPAA and applicable state laws.

Third-Party Services: Our sites may use third-party tools (e.g., maps, embedded videos) under BAAs where PHI is involved; their collection and use of data are governed by their own policies, but we ensure HIPAA alignment. No children's data under 13 is knowingly collected (COPPA compliance).

Changes: We may update this Privacy Policy periodically to reflect 2025 HIPAA and state law evolutions; the “Effective Date” reflects the latest version. Last updated: October 28, 2025.

Accessibility Statement

ReFocus is committed to making our website accessible to people with disabilities. We are actively working to enhance the user experience and implement relevant accessibility standards, including WCAG 2.1 Level AA.

Measures to Support Accessibility

ReFocus takes the following measures to ensure accessibility of refocuseye.com:
Includes accessibility as part of our internal policies and processes.
Assign clear accessibility targets and responsibilities.
Provides continual accessibility training for staff.
Employs formal accessibility quality assurance methods.
Utilizes an accessibility widget (AccessYes) to support user needs.

Conformance Status

The ReFocus website is partially conformant with WCAG 2.1, Level AA. Partially conformant means that some parts of the content do not fully conform to the accessibility standard. No full audit has been conducted yet.

Accessibility Features

We use an accessibility widget provided by AccessYes to support users with diverse needs. The widget includes the following features:
Text resizing.
High contrast and dark mode.
Screen reader enhancements.
Pause or disable animations.
Highlight links and title.
Dyslexia font and motion control for cognitive needs.
You can open the accessibility menu by clicking the icon in the bottom-right corner of any page.

Known Limitations

Some older files, third-party content, or embedded media may not fully meet accessibility standards. We are working on updates and encourage users to notify us if they face any issues.

Feedback and Contact

If you need assistance or wish to report an accessibility issue, please contact us:
Email: rabia.hamid@refocuseye.com
We aim to respond within 3 business days and will do our best to address any issues.

Compatibility with Browsers and Assistive Technologies

This website is designed to be compatible with:
The latest versions of major browsers (e.g., Chrome, Edge, Safari, Firefox).
Assistive technologies such as screen readers (e.g., NVDA, VoiceOver, JAWS).
Mobile accessibility tools (e.g., TalkBack, iOS VoiceOver).

Technical Specifications

This website relies on the following technologies to function as intended and support accessibility:
HTML.
WAI-ARIA.
CSS.
JavaScript.
These technologies are relied upon for conformance with accessibility standards.

Assessment Approach

ReFocus assessed the accessibility of this website using the following approach:
Self-evaluation based on WCAG guidelines.
Manual and automated testing using tools such as axe, WAVE, Lighthouse.
Periodic review and testing after major updates.

Last updated: October 28, 2025.

Ongoing Efforts: Accessibility is an ongoing process. We regularly review content, features, and third-party integrations and make good-faith, commercially reasonable efforts to remediate known issues in a timely manner.

Third-Party Content: Our sites may include third-party content, plug-ins, widgets, forms, videos, or tools that we do not control. While we encourage these providers to support accessibility, we are not responsible for their accessibility practices or content.

No Warranty: We do not warrant that the website or any content, services, or features will be error-free, uninterrupted, or fully accessible on all devices, browsers, or assistive technologies. Compatibility and accessibility can vary based on user software, hardware, and settings.

Informational Only — Not Medical Advice: Content on this website, including text, graphics, images, and videos, is provided for general educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment, and should not be relied upon for specific medical decisions or self-treatment.

No Doctor–Patient Relationship: Your use of this website does not create a doctor–patient relationship with ReFocus, its physicians, or any affiliated providers. Do not disregard professional medical advice or delay seeking care because of something you read here. In an emergency, call 911 or your local emergency number immediately.

Accuracy & Timeliness: While we endeavor to keep information current and accurate, medical knowledge evolves and content may not reflect the most recent research or standards. ReFocus does not guarantee the completeness, accuracy, or timeliness of information on this site; last clinical review: October 1, 2025. Content is not FDA-endorsed if referencing devices or treatments.

Liability Limitation: To the fullest extent permitted by law, ReFocus and its affiliates are not liable for any loss or damage arising from your reliance on information provided on this site.

Vendor Role: Specialty Vision supported website design and content production under the direction and final approval of ReFocus. Specialty Vision does not provide medical advice and makes no medical representations; all clinical content is reviewed and approved by ReFocus and its clinical representatives.

By providing your mobile number and opting in to receive messages from ReFocus, you consent to receive appointment reminders, updates, and promotional texts in compliance with TCPA and HIPAA. For reminders (non-marketing), prior express consent is obtained via number provision; for promotions, prior express written consent is required (e.g., via form checkbox). Be aware that SMS is unencrypted; PHI in texts carries security risks, and you acknowledge these limitations.

• Opt-In: Consent is voluntary and not a condition of receiving care.
• Opt-Out: Reply “STOP” at any time to unsubscribe; we process revocations within 10 minutes per 2025 FCC rules.
• Message Frequency: Varies by interaction (e.g., up to 4 reminders per month); no excessive messaging.
• Rates: Standard message and data rates may apply; check with your carrier.
• Support: Reply “HELP” or email rabia.hamid@refocuseye.com.
• Privacy: Data is not sold and is shared only as necessary to provide messaging services under BAAs or as required by law.

Effective Date: October 1, 2025

Ownership & License: All content on this website (text, graphics, images, videos, design) is owned by ReFocus or used under license. Unauthorized reproduction, distribution, or commercial use is prohibited.

Acceptable Use: You agree not to use the site for unlawful purposes; not to attempt unauthorized access; and not to use, copy, or distribute content for commercial purposes without written permission.

No Warranties: This website and all content are provided “as is” and “as available” without warranties of any kind, express or implied.

Limitation of Liability: To the maximum extent permitted by law, ReFocus, its affiliates, and their respective officers, directors, employees, and agents shall not be liable for any indirect, incidental, consequential, special, or exemplary damages arising out of or relating to your use of the website.

Vendor Role: Specialty Vision is a third-party vendor that supported website design and content production under ReFocus’s direction and final approval. Specialty Vision does not provide medical advice and is not responsible for clinical judgments or outcomes.

Indemnification: You agree to indemnify, defend, and hold harmless ReFocus, its affiliates, and their personnel from and against any claims, losses, or damages arising out of your violation of these Terms or misuse of the website.

Governing Law: These Terms are governed by the laws of the State of Delaware, without regard to conflict-of-law rules, as a primary jurisdiction for our multi-state operations in NY, NJ, CT, MA, PA, RI, VA, DE, and MD. Any disputes shall be resolved through binding arbitration in Delaware, waiving class actions to the extent permitted.

Electronic Communications: You consent to electronic notices and agree these Terms constitute the full agreement.

Contact: Questions regarding these Terms may be directed to:
Director of Quality, Safety, and Compliance
Rabia Hamid – rabia.hamid@refocuseye.com. Last updated: October 28, 2025.