This Privacy Notice is being provided to you as a requirement of a federal law, the Health Insurance Portability and Accountability Act (HIPAA). This Privacy Notice describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information in some cases. Your PHI means any written and oral health information about you, including demographic data that can be used to identify you. This is health information that is created or received by your health care provider, and that relates to your past, present or future physical or mental health or condition.

We may use your protected health information for purposes of providing treatment, obtaining payment for treatment, and conducting health care operations. Your PHI may be used or disclosed only for these purposes unless we have obtained your authorization or the use or disclosure is otherwise permitted by the HIPAA privacy regulations or state law. Disclosures of your PHI for the purposes described in this Privacy Notice may be made in writing, orally, or by facsimile.

1. Treatment.

   We will use and disclose your PHI to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party for treatment purposes. For example, we may disclose your PHI to a pharmacy to fill a prescription or to an optical laboratory to manufacture lenses. We may also disclose PHI to physicians who may be treating you or consulting with us with respect to your care. In some cases, we may also disclose your PHI to an outside treatment provider for purposes of the treatment activities of the other provider.

2. Payment.

   Your PHI will be used, as needed, to obtain payment for the services that we provide. This may include certain communications to your health insurance company to get approval for a procedure that we have scheduled. We may also disclose PHI to your health insurance company to determine whether you are eligible for benefits or whether a particular service is covered under your health plan. In order to get payment for the services we provide to you, we may also need to disclose your PHI to your health insurance company to demonstrate the medical necessity of the services or, as required by your insurance company, for utilization review. We may also disclose patient information to another provider involved in your care for the other provider's payment activities.

3. Operations.

   We may use or disclose your PHI, as necessary, for our own health care operations to facilitate our operations and to provide quality care to all patients. Health care operations include such activities as: quality assessment and improvement activities, employee review activities, training programs including those in which students, trainees, or practitioners in health care learn under supervision, accreditation, certification, licensing or credentialing activities, review and auditing, including compliance reviews, medical reviews, legal services and maintaining compliance programs, and business management and general administrative activities. In certain situations, we may also disclose patient information to another provider or health plan for their health care operations.

4. Other Uses and Disclosures.

   As part of treatment, payment and health care operations, we may also use or disclose your PHI for the following purposes: to remind you of your appointment or surgery date, to inform you that your eyeglasses, contact lenses or other products are available, to inform you of potential treatment alternatives or options, or to inform you of health-related benefits or services that may be of interest to you.

1. When Legally Required.

   We will release PHI if we are legally required to do so.

2. When There Are Risks to Public Health. We may disclose your PHI for the following public activities and purposes:

To prevent, control, or report disease, injury or disability as permitted by law. To report vital events such as birth or death as permitted or required by law. To conduct public health surveillance, investigations and interventions as permitted or required by law. To collect or report adverse events and product defects, track FDA regulated products, enable product recalls, repairs or replacements to the FDA and to conduct post marketing surveillance. To notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease as authorized by law. To report to an employer information about an individual who is a member of the workforce as legally permitted or required.

3. To Report Suspected Abuse, Neglect Or Domestic Violence.

   We may notify government authorities if we believe that a patient is the victim of abuse, neglect or domestic violence.

4. To Conduct Health Oversight Activities.

   We may disclose your PHI to a health oversight agency for activities including audits; civil, administrative, or criminal investigations, proceedings, or actions; inspections; licensure or disciplinary actions; or other activities necessary for appropriate oversight as authorized by law.

5. To Coroners, Funeral Directors, and for Organ Donation.

   We may disclose PHI to a coroner or medical examiner for identification purposes, to determine cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose PHI to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties.

6. In the Event of a Serious Threat to Health or Safety.

   We may, consistent with applicable law and ethical standards of conduct, use or disclose your PHI if we believe, in good faith, that such use or disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.

7. For Specified Government Functions.

   In certain circumstances, federal regulations authorize us to use or disclose your PHI to facilitate specified government functions relating to military and veterans activities, national security and intelligence activities, protective services for the President and others, medical suitability determinations, correctional institutions, and law enforcement custodial situations.

8. For Worker's Compensation.

   We may release your health information to comply with worker's compensation laws or similar programs.

We may disclose your PHI to your family member or a close personal friend if it is directly relevant to the person's involvement in your health care or payment. We can also disclose your information in connection with trying to locate or notify family members or others involved in your care concerning your location, condition or death. You may object to these disclosures. If you do not object to these disclosures or we can infer from the circumstances that you do not object or we determine, in the exercise of our professional judgment, that it is in your best interests for us to make disclosure of information that is directly relevant to the person's involvement with your care, we may disclose your PHI as described.

Other than as stated above, we will not disclose your health information other than with your written authorization. You may revoke your authorization in writing at any time except to the extent that we have taken action in reliance upon the authorization.

1. The right to inspect and copy your PHI.

   You may inspect and obtain a copy of your PHI that is contained in a designated record set for as long as we maintain the PHI. Under federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding; and PHI that is subject to a law that prohibits access to PHI. Depending on the circumstances, you may have the right to have a decision to deny access reviewed. We may deny your request to inspect or copy your PHI if, in our professional judgment, we determine that the access requested is likely to endanger your life or safety or that of another person, or that it is likely to cause substantial harm to another person referenced within the information, You have the right to request a review of this decision. To inspect and obtain a copy of your medical information, you must submit a written request to the Privacy Officer whose contact information is listed at the end of this Privacy Notice. If you request a copy of your information, we may charge you a fee for the costs of copying, mailing or other costs incurred by us in complying with your request.

   Please contact our Privacy Officer if you have questions about access to your medical record.

2. The right to request a restriction on uses and disclosures of your PHI.

   You may ask us not to use or disclose certain parts of your PHI for the purposes of treatment, payment or health care operations. You may also request that we not disclose your health information to family members or friends who may be involved in your care or for notification purposes as described in this Privacy Notice. Your request must state the specific restriction requested and to whom you want the restriction to apply. We are not required to agree to a restriction that you may request. We will notify you if we deny your request to a restriction. If the facility does agree to the requested restriction, we may not use or disclose your PHI in violation of that restriction unless it is needed to provide emergency treatment. Under certain circumstances, we may terminate our agreement to a restriction. You may request a restriction by contacting the Privacy Officer.

3. The right to request to receive confidential communications from us by alternative means or at an alternative location.

   You have the right to request that we communicate with you in certain ways. We will accommodate reasonable requests. We may condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. We will not require you to provide an explanation for your request. Requests must be made in writing to our Privacy Officer.

4. The right to request amendments to your PHI.

   You may request an amendment of PHI about you. In certain cases, we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Requests for amendment must be in writing and must be directed to our Privacy Officer. In this written request, you must also provide a reason to support the requested amendments.

5. The right to receive an accounting.

   You have the right to request an accounting of certain disclosures of your PHI. This right applies to disclosures for purposes other than treatment, payment or health care operations as described in this Privacy Notice. We are also not required to account for disclosures that you requested, disclosures that you agreed to by signing an authorization form, to friends or family members involved in your care, or certain other disclosures we are permitted to make without your authorization. The request for an accounting must be made in writing to our Privacy Officer. The request should specify the time period sought for the accounting. We are not required to provide an accounting for disclosures that take place prior to April 14, 2003. Accounting requests may not be made for periods of time in excess of six years. We will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.

6. The right to obtain a paper copy of this notice.

   Upon request, we will provide a separate paper copy of this notice even if you have already received a copy of the notice or have agreed to accept this notice electronically.

We are required by law to maintain the privacy of your health information and to provide you with this Privacy Notice of our duties and privacy practices. We are required to abide by terms of this Notice as may be amended from time to time. We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all future PHI that we maintain. If we change this Notice, we will provide a copy of the revised Notice through in-person contact.

You have the right to express complaints to us and to the Secretary of Health and Human Services if you believe that your privacy rights have been violated. You may complain to us by contacting the facility' s Privacy Officer in writing, using the contact information below. You will not be retaliated against in any way for filing a complaint.

The facility's contact person for all issues regarding patient privacy and your rights under the federal privacy standards is the Privacy Officer. Information regarding matters covered by this Notice can be requested by contacting the Privacy Officer. If you feel that your privacy rights have been violated by us you may submit a complaint to our Privacy Officer by sending it to:

This Notice is effective April 14, 2003.