NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFOMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This Notice describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information.

TREATMENT, PAYMENT AND HEALTHCARE OPERATIONS The most common reason why we use or disclose your health information is for treatment, payment, or healthcare operations. Examples of how we use or disclose information for treatment purposes are: setting up an appointment; calling you by name in the waiting room; testing or examining your eyes; prescribing glasses, contact lenses, or eye medications and phoning/faxing them to be filled; showing you low-vision aids; referring you to anoher doctor or clinic for eye care or low-vision aids or services; or getting copies of you health information from another professional that you may have seen before us. Examples of how we use or disclose your health information for payment purposes are: asking you about your health or vision care plans, or other sources of payment; preparing and sending bills and claims; and collecting unpaid amounts (either ourselves or through a collection agency or attorney). Healthcare operations mean those administrative or managerial functions that we perform in order to run our office. Examples of how we use or disclose your health information for healthcare operations are: financial or billing audits; internal quality assurance; personnel decisions; participation in managed-care plans; defense of legal matter; business planning; and outside storage of our records. We routinely use your health information for these purposes without any special permission.

USES AND DISCLOSURES FOR OTHER REASONS WITHOUT PERMISSION In some limited situations the law allows or requires us to use or disclose you health information without your permission. Not all of these situations will apply to us. Some may never come up at our office at all. These situations include: as required by law, for public health purposes, i.e. contagious disease reporting; health oversight, abuse or neglect, FDA requirements, legal proceedings; law enforcement; research, military activity and national security; worker's compensation; disclosures of de-idenified information; incidental disclosures that are an unaviodable by-product of permitted uses and disclosures; disclosures to business associates who perform healthare operations for us and who commit to respect the privacy of your health information. Unless you object, we will share relevant information about your care with your family or friends who are helping with your eye care.

APPOINTMENT REMINDERS We may call or write to remind you of scheduled appointments, or that it is time to make a routine appointment. We may also call or write to notify you of other treatment or services available at our office that might help you. Unless you tell us other wise, we will mail you an appointment reminder on a post card, and/or leave you a reminder message on an answering machine or with someone who answers your phone.

OTHER USES AND DISCLOSURES We will not make any other uses or disclosures of your health information unless you sign a written "authorization form". If you do sign one, you may revoke it at any time unless we have already acted in reliance upon it. Revocations must be in writing.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION The law gives you many rights regarding your health information. You have a right to: > Inspect and obtain a photocopy of your health information. By law there are a few limited situations in which we can refuse access or copying. > Ask us to restrict our uses and disclosures for purposes of treatment (except emergeny treatment), payment or healthcare operations. We do not have to agree to this. If the optometrist believes it is in your best interest to permit use and disclosure of your protected health information, your protected health information will not be restricted. > Ask to receive confidential communications from us by alernative means or at an alternative location. > Ask us to amend your health information if you think it is incorrect or incomplete. 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. > Receive an accounting of certain disclosures we have made, if any, of your protected health information. > Obtain a paper copy of this Notice of Privacy Practices. If you wish to exercise any of these rights, send a request in writing to our office, attention: HIPAA Compliance Officer.

CHANGES TO THIS NOTICE OF PRIVACY PRACTICES We reserve the right to change the terms of this notice at any time as allowed by law. If we change this notie, the new privacy practices will apply to your helath information that we already have as well as to such information that we may generate in the future. If we change this Notice of Privacy Practices, we will post the new Notice in our office and have copies available in the office.

COMPLAINTS You may omplain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. We will not retaliate against you if you make a complaint. If you want to complain to us, send a writen complaint to our office attention: HIPAA Compliance Officer. Or, if you prefer, our compliance officer can discuss your complaint in person or by phone.

This Notice was published and becomes effective on April 14, 2003.