privacy policy

Patient Policies: Privacy, Appointments, and Payments
Effective Date: January 1, 2026

This Notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully. If you have any questions, please contact our office.

1) Appointment Policies
Cancellation / No-Show Policy

• A $35 no-show fee will be charged for:

  • Missed appointments, or

  • Appointments canceled with less than 24 hours’ notice

• If you need to cancel or reschedule, please call at least 24 hours in advance during our business hours.

• We understand emergencies happen and will work with patients when a true medical/emergent situation arises. Please notify our office as soon as possible.

Contact Lens Reminder
If you wear contact lenses and would like your prescription updated, please wear your contact lenses to your exam.

2) Payment & Insurance Reminders
Payment Methods

• We accept credit cards for payment.

• Please note: a 4% credit card processing fee applies. This fee is charged directly by the credit card company.

  • This fee also applies to HSA cards.

• If you prefer to avoid the processing fee, we are happy to accept printed checks.

Co-Pays

• Co-pays are due at the time of your exam.

Refraction Fee Update

• The refraction fee will be increasing from $50 to $55.

• This primarily applies to private pay patients or those without vision plans.

• Most vision plans will continue to cover refraction as they always have.

3) Notice of Privacy Practices
Our Legal Duties
We are required by law to:

• Maintain the privacy of your protected health information (PHI)

• Provide you with this notice of our legal duties and privacy practices regarding your health information

• Follow the terms of the notice currently in effect

How We May Use and Disclose Your Health Information
The following describes the ways we may use and disclose health information that identifies you (“Health Information” or “PHI”). Except for the purposes below, we will use and disclose Health Information only with your written permission. You may revoke such permission at any time by writing to us.

Treatment
We may use and disclose PHI for your treatment and to provide treatment-related health care services (including sharing information with providers and staff involved in your care).

Payment
We may use and disclose PHI to bill and receive payment from you, an insurance company, or a third party.
If you pay for services out-of-pocket and request that we not disclose information to a health plan, we will comply as permitted by law.

Health Care Operations
We may use and disclose PHI for office operations that support quality care and practice management.

Appointment Reminders, Treatment Alternatives, and Health-Related Benefits
We may contact you to remind you of appointments and provide information about treatment alternatives or health-related services that may be of interest to you. We will not send communications about subsidized products/services without your authorization.

Individuals Involved in Your Care
When appropriate, we may share PHI with a person involved in your care or payment (such as family or a close friend), unless you object.

Research
Under certain circumstances, we may use and disclose PHI for research, subject to required approval processes.

Fundraising and Marketing
PHI may be used for fundraising communications and you may opt out. Uses/disclosures for marketing purposes or disclosures that constitute a sale of PHI require your authorization when applicable.

Other Uses
Other uses and disclosures not described in this Notice may be made only with your authorization.

Special Situations
We may disclose PHI:

• As required by law

• To avert a serious threat to health or safety

• To business associates performing services on our behalf (who must protect your information)

• For organ and tissue donation

• For military/veteran activities

• For workers’ compensation

• For public health activities

• For health oversight activities

• For lawsuits and legal proceedings (as required by lawful process)

• For law enforcement purposes (as permitted by law)

• To coroners/medical examiners/funeral directors

• For national security/intelligence activities

• For protective services for the President and others

• For inmates or individuals in custody (as permitted by law)

Your Rights
You have the right to:

• Inspect and copy your PHI (medical and billing records, excluding psychotherapy notes)

• Request amendments to your PHI

• Request an accounting of certain disclosures

• Request restrictions on certain uses/disclosures (we are not required to agree to all requests)

• Request confidential communications

• Obtain a paper copy of this Notice

• Receive electronic records in electronic form

• Receive breach notification if unsecured PHI is improperly disclosed

All requests must be made in writing.

Changes to This Notice
We reserve the right to change this Notice and apply the new notice to PHI we already have and any information we receive in the future. A copy of the current notice will be posted in our office and will include the effective date.

Complaints
If you believe your privacy rights have been violated, you may file a written complaint with our office or with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.

Privacy Contact Officer: Call Office