The information you supply via this appointment form is considered strictly confidential and will never willingly be shared with anyone without your explicit permission.  Some people are concerned about information on the Internet being "hijacked" by hackers.  This concern may be valid not only for the Internet, but for any communications by any method, be it wireless telephone, a cell phone, a FAX machine or any other communications device.  Although this web page is protected by 128 bit encryption security, Quality Eye Care, P.C. cannot guarantee the security of the information you submit using this form as it pertains to electronic transmittal.  If you deem the information we ask for to be sensitive, the only way to ensure its absolute security is to discuss it with the doctor face-to-face.  We encourage you to do so by requesting an appointment by phone.