THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

PLEASE REVIEW IT CAREFULLY. THE PRIVACY OF YOUR HEALTH IS IMPORTANT TO US. ______________________________________________

OUR LEGAL DUTY

We are required by law to maintain the privacy of your 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. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect April 14, 2003, and will remain in effect until we replace it.

We reserve the right to change our privacy practices and terms of this Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make changes in our privacy practices and the new terms of our Notice effective for all health information that we mainitain, including health information we created or received before we made the changes.

You may request a copy of the Notice at any time by simply contacting us with your request. ______________________________________________

USES AND DISCLOSURES OF HEALTH INFORMATION

We use and disclose health informaiton about you for treatment, payment, and healthcare operations. For example:

TREATMENT: We may use or disclose your health informaiton to an optician, ophthalmologist or other healthcare provider providing treatment to you for: a.) the provision, coordination, or management of health care and related services by health care providers; b) consultation between health care providers relating to a patient; c) the referral of a patient for healthcare from one health care provider to another; or d) recall information.

PAYMENT: we may use and disclose your health information to obtain payment ofr services we provide to you. This may include: a)billing and collection activities and related data processing; b)actions by a health plan or insurer to obtain premiums or to determine or fulfill its responsibilities for coverage and provisions of benefits under its health plan or insurance agreement, determination of eligibility or coverage, adjudication or subrogation of health benefit claims; c) medical neccessity and appropriateness of care review, utilization review activities; and d)disclosure to consumer reporting agencies of informaiton relating to collection of premiums or reimbursement.

OTHER: In some limited situations, the law allows or requires us to disclose or use your health information without you permission. Not all of these situations will apply to us; some may never come up in our office at all. Such uses or disclosures are:

When a state or federal law mandates that certain health information be reported for a specefic purpose;

For public health purposes, such as a contagious disease reporting, investigation or surveillance; and notices to and from the Federal Food and Drug Administration regarding drugs and medical devices;

Disclosures to governmental authorities about victims suspected of abuse, neglect, or domestic violence;