This Notice of Privacy Practices is provided for
educational and informational purposes only. This
Notice is not intended as legal advice, and is not
provided for adoption or publication by any party.
The publication of any such notice may create
legal obligations or liabilities which may vary
depending upon the legal status and business
operations of different organizations. The form and
content of any Notice of Privacy Practices should
be determined only upon informed consultation
with qualified legal counsel.

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 12/12/02 UNTIL
FURTHER NOTICE.

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),
Visualeyes Optometry 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.
b) Payment - We may use and disclose your health
information to obtain payment for services we
provide you.
c) Health care operations - We may use and
disclose your health information in connection with
our healthcare operations. Healthcare operations
include quality assessment and improvement
activities, reviewing the competency or
qualifications of healthcare professionals,
evaluating provider performance, conducting
training programs, accreditation, certification,
licensing or credentialing activities.

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
healthcare.

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

Required by Law
We may also use or disclose your health
information when we are required to do so by law.

Abuse or Neglect
We may disclose your health information 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
people's health or safety.

National Security
We may disclose the health information of Armed
Forces personnel to military authorities under
certain circumstances. We may disclose health
information to authorized federal officials required
for lawful intelligence, counterintelligence and
other national security activities. We may disclose
health information of inmates or patients to the
appropriate authorities under certain
circumstances.

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 restriction may 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 paper copy of this notice of
privacy practices.

Legal Requirements
Visualeyes Optometry is required by law to
maintain the privacy of your protected health
information. We are required 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 will not be in effect until they are posted
to this site, or are available within our office.

Complaints
If you have complaints regarding the way your
protected health information was handled, you may
submit a complaint in writing to our office. You will
not be retaliated against in any manner for a
complaint.

Contact Information
For further information about Visualeyes
Optometry's privacy policies, please contact Dr.
Susan Kim at the following address or phone
number:
Visualeyes Optometry
4555 Hopyard Rd. Ste C-19
Pleasanton, CA 94588
(925)463-7330