Notice of Privacy Practice
This notice describes how your health informaiton may be used and disclosed. Please review it carefully.
1. At Southwest Orlando Eye Care, we have always kept your health information secure and confident.
2. A law requires us to continue maintaining your privacy, to give you this notice, and to follow the terms of this notice.
3. The law permits us to use or disclose your health information to those involved in your treatment. For example a review of your file by a specialist doctor whom we may involve in your care.
4. We may use or disclose your health information for payment of your services. For example, we may send a report of your progress to your insurance company.
5. We may use or disclose your health information for our normal healthcare operations. For example, one of your staff will enter your information into our computer.
6. We may use your information to contact you. For example, we may send newsletters or other information. We may also want to call and remind you about your appointments. If you are not home, we may leave this information on your answering machine or with the person who answers the call.
7. In an emergency, we may disclose your health information to a family member or another person responsible for your care.
8. We may release some or all of your health information when required by law.
9. You may request in writing that we not use or disclose your health information as described above.
10. As we will need to contact you from time to time, we will use whatever address, telephone numbers, or email address we have on file.
11. You have the right to transfer copies of your health information to another practice.
12. You have the right to see and receive a copy of your health information, with a few exceptions. Give us a written request or sign a records request form in regards to the information you are requesting.
13. If we change the details of this notice, we will notify you of the changes in writing.
14. You may file a complaint with the Department of Health and Human Services, 200 Independence Avenue, S.W., Room 509F, Washington, D.C. 20201.
15. However, before filing a complaint, or for more information or assistance regarding you health information privacy, please contact our office at 407-270-2217.
I have received a copy of the Southwest Orlando Eye Care Notice of Privacy Practices. Returns or cancellations of glasses or contacts are made at the discretion of this office. An in office credit will be issued. Progressive lenses have a non-adapt 90 day warranty, which means we can exchange the lenses for single vision or lined bifocal lenses. Ophthalmic lenses for glasses are custom made for you.