Privacy Notice

NOTICE OF PRIVACY PRACTICES

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.

We care about our patient's privacy and strive to protect the confidentiality of your medical information at this practice. You have the right to the privacy of your medical information, and this practice is required by law to maintain the privacy of that protected health information.

WHO WILL FOLLOW THIS NOTICE:
Any health care professional authorized to enter information into your medical record, all employees, staff and other personnel at this practice who may need access to your information must abide by this Notice.

Under the HIPAA ACT, G. BARNARD WILSON,O.D. can use your protected health information for treatment, payment and health care operations without your authorization. Other uses or disclosures that can be made without your Consent or Authorization include:*as required by law enforcement agencies,to avert a serious threat to public health or safety, to worker's compensation or similar programs for processing of claims, in response to a legal proceeding, to a coroner or medical examiner for id of a body,as required by the FDA,uses and disclosures in domestic violence or abuse/neglect situations, health oversite activities and other public health activities.

We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that my be of interest to you.

USES AND DISCLOSURES OF PROTESTED HEALTH INFORMATION REQUIRING YOUR WRITTEN AUTHORIZATION: Other uses and disclosures of medical information not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you give us authorization, yop may revoke that authorization, in writing, at any time. You understand that we are unable to take back any disclosures we have already made with your authorization, and that we are required to retain our records for the care we have provided you.

YOUR INDIVIDUAL RIGHTS REGARDING YOUR MEDICAL INFORMATION: If you believe your privacy rights have been violated, you may file a complaint (in writing) with G. Barnard Wilson, O.D. or with the Sectarty of the Dept. of Health or Human Services.

YOU HAVE THE RIGHT: to request restrictions or limitation on the medical informations that we release. We are not required to agree with your request. To request restrictions, you must submit it in writing.
to request confidential communications (i.e. reminders or correspondence regarding your medical matters). Your request must specify how or where you wish to be contacted. To inspect and copy records. Usually this includes medical and billing records; but, not psychotherapy records, information compiled for use in a civil, criminal, or administrative action and protected health information to which access is prohibited by law. You must submit your request in writing to G. Barnard Wilson, O.D. Right to amend: if you feel that the medical information we have about you is incorrect or imcomplete, you may request (in writing) an amendment be placed in your file. We may deny your request if it does not provide a reason to support yur request. You have the right to file a disagreement with our decision. And, we may rebutt your disagreement. All of the correponsence (disagreements/rebuttals) remain in the file. Right to an accounting of non-standard disclosures: You may request (in writing)a list of disclosures we made of medical information about you. Your request must state the time period for which you want to receive a list of disclosures that is no longer than six years and may not include dates before April 14, 2003.

Right to a paper copy of our Notice: You have a right to a paper copy of our Notice at any time. To obtain a paper copy of our current Notice, please request one in writing from G. Barnard Wilson, O.D.

CHANGES TO THIS NOTICE: We reserve the right to change this Notice. We reserve the right to make revised or changes Notice effective for medical information we already have about you as well as any information we receive in the future.

TO CONTACT OUR OFFICE: G. BARNARD WILSON,O.D.
lOCATION #1
1317 Oakdale Rd. #620 Modesto, Ca. 95355
(209) 524-7870 Fax (209) 524-7985

Location #2
1150 W. Robinhood Dr. A-2 Stockton, Ca. 95207
(209) 951-0498 Fax (209) 951-0501