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.

OUR PLEDGE REGARDING YOUR HEALTH INFORMATION
We are committed to protecting the privacy of your health information. We create a record of the care and services you receive to provide quality care and comply with legal requirements. This notice applies to all records of your care generated by Greeley Eye Doctors
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HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
​The following categories describe ways we may use and disclose your PHI without your authorization:

1. Treatment – To provide, coordinate, or manage your healthcare.
2. Payment – To bill and obtain payment from you, insurance, or another third party.
3. Healthcare Operations – For administrative activities, improving care, and evaluating staff performance.
4. Appointment Reminders/Treatment Alternatives – To contact you about appointments or inform you of treatment options.
5. As Required by Law – For public health activities, reporting abuse/neglect, legal proceedings, law enforcement, and other government requests.
6. Other Uses – Such as workers' compensation, coroners, or organ donation (as permitted or required by law).

Other uses and disclosures (e.g., marketing, research, psychotherapy notes) require your written authorization.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the right to:

• Request Restrictions – Ask us to limit how we use/disclose your PHI (we are not always required to agree).
• Confidential Communications – Request that we contact you in a specific way (e.g., only at home).
• Inspect and Copy – Access and obtain a copy of your medical records (may involve fees).
• Request Amendments – Ask us to correct incorrect or incomplete PHI.
• Receive an Accounting of Disclosures – Get a list of certain disclosures made in the past six years.
• Obtain a Paper Copy of This Notice – Even if you received it electronically.

​CHANGES TO THIS NOTICE
We reserve the right to update this notice. Revised notices will be posted in our facility and on our website (if applicable) and will be available upon request.

COMPLAINTS
​If you believe your privacy rights have been violated, you may file a complaint with:

• Our Privacy Officer at [Contact Information]
• The U.S. Department of Health and Human Services (HHS) – Office for Civil Rights Complaint Portal

You will not be penalized for filing a complaint.
QUESTIONS?Contact our Privacy Officer at 970-506-9999 or [email protected] for more information.