HIPAA Notice of
Privacy Practices

We use your health information primarily for three purposes: treatment, payment, and operational needs. We may use or disclose your medical information without specific permission for these routine functions, though you retain rights to request restrictions.

Treatment uses include appointment scheduling, contacting you about eyeglass or contact lens orders, prescribing glasses and medications, referring you to specialists, and maintaining communication through phone, email, or text.

Payment uses involve billing insurance companies, collecting payment information, and preparing statements. You may request that out-of-pocket care details not be shared with health plans.

Operational uses encompass quality assurance, audits, licensing compliance, and government agency reporting related to public safety or disability certification.

We may disclose your information without authorization for:

• Public health emergencies or disease reporting
• Law enforcement inquiries about suspected abuse or crimes
• Court orders or subpoenas
• Organ donation coordination
• Medical examiner requests
• Workplace compensation claims
• De-identified research data

Staff may discuss appointment status and delivery of optical goods with individuals calling on your behalf, without disclosing health information. The presence of third parties in treatment areas implies consent to information sharing.

You have the right to:

• Request restrictions on information use (though we need not agree)
• Request confidential communication methods
• Access or obtain copies of your medical records within state-mandated timeframes
• Request amendments to incorrect information
• Receive a list of non-routine disclosures annually
• Obtain additional copies of this notice

We are committed to notifying affected individuals, business associates, and appropriate government agencies if a reportable data breach occurs, following all HIPAA requirements.

You may file complaints with our Privacy Officer or the U.S. Department of Health and Human Services Office of Civil Rights without fear of retaliation. To reach our Privacy Officer, contact:

Kyle Cooke, OD — Privacy Officer
990 US 287, Ste. 109, Mansfield, TX 76063
(817) 453-4682