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

THIS NOTICE IS EFFECTIVE 04-14-2003

RIGHT TO NOTICE As a patient, you have the right to adequate notice of the uses and disclosures of your protected health information. Under the Health Insurance Portability and Accessibility Act (HIPAA), Optometrice Center of Menifee Valley can use your protected health information for treatment, payment and health care operations. a)Treatment - We may use or disclose your health information to a physician or other healthcare provider providing treatment to you. When we phone to let you know that your glasses or contact lenses are ready to be picked up. b)Payment - We may use and disclose your health information to obtain payment for services we provide you. c)Healthcare operations - We may use and disclose your health information in connection with our healthcare operations. Healthcare operations include those administrative and monagerial functions that we have to do in order to run our office. We may use or disclose your health information, for example, for financial or billing audits, for internal quality assurance, for personnel decisions, to enable our doctors to partivipate in managed care plans, for the defense of legal matter, to develop business plans, and for outside storage of our records.

Your Authorization Most uses and disclosures that do not fall under treatment, payment, health care operations will require your written authorization. Upon signing, you may revoke your authorization (in writing) through our practice at any time.

Emergency Situations In the event of your incapacity or an emergency situation, we will disclose health information to a family member, or another person responsible for your care, using our professional judgment. We will only disclose health information that is directly relevant to the person's involvement in your health care.

Marketing We will not use your helath information for marketing communications without your written authorization.

Abuse or Neglect We may disclose your health informaiton to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to your or other peopl's health or safety.

Appointment Reminders We may use or disclose your health information to provide you with appointment reminders via phone, e-mail or letter.

YOur Rights as a Patient You have the right to restrict the disclosure of your protected health information (in writing). The request for restrictionmay be denied if the information is required for treatment, payment or health care operations. -You have the right to receive confidential communications regarding your protected health information. -You have the right to inspect and copy your protected health information. -You have the right to amend your protected health information. -You have the right to receive an account of disclosures of your protected health information. -You have the right to a copy of this notice of privacy practices.

Legal Requirements Optometric Center of Menifee Valley is required by law to maintain the privacy of your protected health information. We are require to abide by the terms of this notice as it is currently stated, and reserve the right to change this notice. The policies in any new notice willnot be in effect until they are posted to this site, or are available within our office.

Complaints If you think that we have not properly respected the privacy of your health information, you are free to complain to us or to the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you if you make a complaint. If you want to complain to us, send a written complaint to us.

Contact Information For further information about Optometric Center of Menifee Valley's privacy policies, please contact Dr. Reggie Ragsdale at the following address or phone number: Optometric Center of Menifee Valley 29950 Haun Road, Suite 206 Menifee, CA 92586 (909) 679-0545