Family Eyecare of Winterset, PC.. Privacy Notice(summary)

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

This summary notice describes Family Eyecare of Winterset, P.C. practices regarding the use of your medical and demographic information. Two request a full copy of our privacy notice, or if you have any questions about this notice, please contact our privacy officer at the address listed below.

We understand that medical information about you and your health is personal. Protecting medical information about you is important. We are required by law to keep medical information that identifies you private; to give you notice of our legal duties and privacy practices with respect to your protected health information; and to follow the terms of this notice.

We create a record of the care and services you receive. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by Family Eyecare of Winterset, P.C., whether made by health care professionals or other personnel.

If the practice described in this document meet your expectations, there is nothing you need to do. if you prefer that we not share information we may honor your written request in certain circumstances.

HOW WE MAY USE AND DISCLOSE PROTECTED INFORMATION ABOUT YOU

We may use protected health information about you for treatment, payment and health care purposes. Additionally we may contact you regarding treatment alternatives ; health-related benefits and services; marketing of health-related benefits and services; and information regarding the Family Eyecare of Winterset, P.C. You may decline to receive this type of information.

We may contact you for appointment reminders and may also leave a message on your answering machine or with a family member or others involved in your health care.

We may release protected health information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care.

Under certain circumstances, we may use and disclose protected health information about you for research purposes. All research projects, however, are subject to a special Family Eyecare of Winterset, P.C. approval process. We will almost always ask for your specific permission if the researcher will have access to your name, address, or other information that reveals who your are or will be involved in your care at Family Eyecare of Winterset, P.C.

We will disclose protected health information about you when required to do so by federal, state or local law. Additionally, we may use and disclose protected health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.

There are other special situations where we may release protected health information such as to organizations that handle organ procurement or organ transplantation; to military command authorities if you are a member of the armed forces; to workers' compensation or similar programs that provide benefits for work-related injuries or illness.

We may also disclose protected health information to a health oversight agency for activities authorized by law such as audits, investigations, inspections, and licensure. We may disclose protected health information about you for public health activities; lawful orders from a court; to a law enforcement official as part of law enforcement activities; to a coroner or medical examiner, to authorized federal officials; or to a correctional institution or law enforcement official if you are an inmate.

YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION ABOUT YOU

You have the following rights regarding your protected health information:

* to receive notice of our policies and procedures used to protect your health information

* to access your protected health information; provided, however, such request be in writing and may be denied in certain limited situations

* to request that your protected health information be amended; provided however, such request be in writing and may be denied in certain limited situations

* to obtain an accounting of certain disclosures by us of your protected health information be restricted; provided, however, we have the right to refuse your request

* to request communications of your protected health information are done by reasonable alternative means or at alternative locations

* to revoke any prior authorizations for use or disclosure of protected health information; except to the extent that action has already taken place

CHANGES TO THIS NOTICE
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. We will post a copy of the current notice. The notice will contain on the first page in the top right hand corner, the effective date.

COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with Family Eyecare of Winterset, P.C., with the Secretary of the Department of Health and Human Services, or the Office of Civil Rights. To file a complaint with Family Eyecare of Winterset, P.C., contact our office at the address and phone number listed below. All complaints must be submitted in writing.

You will not be penalized for filing a complaint.

FAMILY EYECARE OF WINTERSET P.C. 102 N. 1st AVENUE WINTERSET, IA 50273 PHONE (515)462-1254 FAX (515)462-2895