Privacy Notice

Effective date of notice: April 14, 2003

The privacy of your health information is important to us. We are obligated by law to give you our Notice of Privacy Practices. This notice describes how medical information about you may be used and disclosed. It also describes how you may access this information. Please review it carefully

TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS

The most common reasons we use or disclose your health information are for treatment, payment, or health care operations. We will routinely use your health information inside and outside our office for these purposes without any special permissionand are allowed to do so by law. For example:
Treatment: Scheduling and confirming appointments, testing or examining your eyes, prescribing corrective lenses or medication by fax or phone, referring you to and receiving copies of your health information from other doctors.

Payment: Asking about your insurance plans, obtaining reimbursement for services and collecting unpaid amounts, preparing and sending bills or claims.

Health care operations: administrative and managerial functions, financial or billing audits, internal quality assurance, participation in managed care plans, defense of legal matters, and storage of records.

USES AND DISCLOSURES FOR OTHER REASONS WITHOUT PERMISSION

\tIn some limited situations, the law allows or requires us to use or disclose your health information without your permission. Not all of these situations will apply to us; some may never come up at our office at all. Such uses or disclosures may include:

- when law requires that certain health information be reported for a specific purpose;

- for public health purposes, such as contagious disease reporting, and notices to and from the FDA;

- uses and disclosures for health oversight activities, such as for the licensing of doctors;

- uses or disclosures for health related research or disclosures for research or education that do not include personal identification;

- giving disclosures to organizations that handle organ or tissue donations;

- uses and disclosures to prevent a serious threat to health or safety;

- incidental disclosures that are an unavoidable by-product of permitted disclosures;

- disclosures to ?business associates? who perform health care operations for us and who commit to respect the privacy of your health information.

\tUnless you object to our Privacy Officer at the address listed on the home page, we will also share relevant information about your care with your family or other individuals who are helping you with your eye care.

APPOINTMENTS AND SERVICES

\tWe may call or write to remind you of or schedule appointments. We may also call, e-mail, or write to notify you of other treatments or services available at our office. Unless you request otherwise, we will mail you an appointment reminder on a post card, and/or leave you a reminder message on your home or work answering machine or with someone who answers your phone if you are not available.

OTHER USES AND DISCLOSURES

We will not make any other uses or disclosures of your health information without a signed written authorization form. You may revoke the authorization at any time unless we have already acted in reliance upon it. Revocations must be in writing. Send them to our Privacy Officer at the address listed on the home page.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

The law gives you many rights regarding your health information. You can:

- ask us to restrict our uses and disclosures for purposes of treatment (except emergency treatment), payment or health care operations. We do not have to agree to do this, but if we agree, we must honor the restrictions that you want.

- ask us to communicate with you in a confidential way, such as by phoning you at work rather than at home. We will accommodate these requests if they are reasonable.

- ask to see or to get photocopies of your health information. By law, there are a few limited situations in which we can refuse to permit access or copying. For the most part, however, you will be able to review or have a copy of your health information within 30 days of your request. There may be a charge for photocopying.

- ask us to amend your health information if you think that it is incorrect or incomplete. If we agree, we will amend the information within 60 days from your request. If we do not agree, you can write a statement of your position, and we will include it with your health information.

- receive a list of the disclosures that we have made of your health information within the past six years. By law, the list will not include disclosures stated above or those that you authorize.

- receive additional paper copies of this Notice of Privacy Practices upon request.

\tRequests regarding your rights listed above may be made to our Privacy Officer by writing to our address, fax or E Mail on our home page.

OUR NOTICE OF PRIVACY PRACTICES

By law we are bound by the terms of this Notice of Privacy Practices. We reserve the right to change this notice at any time as allowed by law. If we change this Notice, the new privacy practices will apply to your health information that we already have as well as to information that we may generate in the future. If we change our Notice of Privacy Practices, we will post the new notice in our office, have copies available in our office, and post it on our Web site.

COMPLAINTS

Complaints regarding the protection of your health information may be made to our Privacy Officer or to the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you if you make a complaint. Complaints may be made in writing, by phone, or in person.

FOR MORE INFORMATION

If you want more information about our privacy practices, call or visit our Privacy Officer at the address or phone number shown on our home page.