Notice of Privacy Practices

Effectice: April 14,2003

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Our Legal Duty

We are required by applicable Federal and California state law to maintain the privacy of you health information. We are also required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your health information.

Changes to this Notice

We will abide by the terms of this Notice but reserve the right to change the terms of this Notice and to make the new notice provisions effective for all protected health information that we maintain. An updated version of the Notice may be obtained from the Privacy Officer,  Dr. Gordon Wong, whose address is 66 East Washington Street, Petaluma, CA 94952.

Uses and Disclosures of Health Information

We disclose the health information about you for the sole purpose of treatment, payment and healthcare operations. For example:

Treatment: We may use your health information to provide optometric goods and services to you. For example, we may disclose your health information to another healthcare provider in order to: A) provide, coordinate, or manage the healthcare and related services that are provided to you by healthcare practitioners; B) Enable you healthcare providers to consult about your vision; C) Reder you to a new healthcare provider; or D) to contat you in the event of a product recall.

Payment: We may use and disclose medical information about you in order to be paid for optometric goods and services rendered to you. This may include contacting your health insurer to determine the existance of insurance coverage for the goods and services you recieve, sending copies or excerpts of your health information to your health insurer to recieve payment, using your health information for our own internal management of the billing process. For example, a bill sent to your vision insurance company may include information that identifies you and the procedures used to provide services to you.

Healthcare Operations: We may use or fisclose your health information in connection with those activities that we as an optometric practice must do to run smoothly and efficiently. For example, we may use or disclose your information to provide you with appointment card reminders, treatment alternatives, or other health-related benefits and services that may be of interest to you. Such activities, accreditations, certifications, licensing, or credentialing activities, and periodic reviews by your vision plan.