The Optical at 5oth and France
NOTICE OF PRIVACY PRACTICES
Please read this notice carefully. It
describes how medical information about you may be used
and disclosed, as well as how you can review and control
disclosure.
During your treatment at
The Optical at 50th and France, our opticians may gather information about your medical history and your current eye health. This notice explains how that information may be used and shared with others. It also explains your privacy rights regarding this kind of information. The terms of this notice apply to health information created or received by The Optical
at 50th and France. We are required by law to: make sure that medical information that identifies you is kept private; give you this notice of our legal duties and privacy practices with respect to medical information about you; and follow the terms of the notice that is currently in effect.
Changes to This Notice
The effective date of this notice is December 1, 2007. We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you, as well as any information we receive in the future. If the terms of this notice are changed,
The Optical at 50th and France will provide you with a revised notice upon request, and we will post the revised notice in designated locations at the
The Optical at 50th and France. If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with the
The Optical at 50th and France, please submit it in writing to
our mailing address. The Optical
at 50th and France will not use or disclose
your protected health information without a specific
written authorization from you. If you provide us
with this written authorization to use or disclose
medical information about you, you may revoke that
authorization, in writing, at any time. If you
revoke your authorization, we will no longer use or
disclose medical information about you for the reasons
covered by your written authorization, except to the
extent we have already relied on your authorization.
We are unable to take back any disclosures we have
already made with your permission, and we are required
by law to retain the records of the care that we
provided to you while we were providing your care.
|