Privacy Policy

Effective Date: December 2025

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.

1. Your medical information is personal. Eye Physicians & Surgeons of Arizona is a covered entity under HIPAA and is required by law to maintain the privacy of your personal health information (“PHI”). We are required to provide you with this Notice of our legal duties and privacy practices and to notify affected individuals following a breach of unsecured PHI.

2. Permitted Disclosures of PHI. We may disclose your PHI without your authorization for the following reasons:
a. Treatment. We may disclose your PHI to physicians or other healthcare providers who are involved in your care.
b. Payment. We may disclose your PHI to bill and collect payment for services we provide.
c. Health Care Operations. We may use or disclose your PHI in connection with our operations—quality assessment, reviewing provider qualifications, etc.
d. Emergency Treatment. We may disclose your PHI if you require emergency treatment or are unable to communicate.
e. Family and Friends. We may disclose your PHI to a family member or other person involved in your care or payment, unless you object.
f. Required by Law. We may disclose your PHI to comply with laws—law enforcement, abuse reporting, etc.
g. Serious Threat to Health or Safety. We may disclose your PHI if necessary to prevent a serious threat to your health or safety or that of others.
h. Public Health. We may disclose your PHI for public health purposes.
i. Health Oversight Activities. We may disclose your PHI to oversight agencies for audits, investigations, licensure actions.
j. Research. We may disclose your PHI for certain research purposes when protections are in place.
k. Workers’ Compensation. We may disclose your PHI to comply with workers’ compensation laws.
l. Specialized Government Functions. We may disclose your PHI for military or intelligence functions, etc.
m. Coroners, Medical Examiners, Funeral Directors. We may disclose PHI as needed for these functions.
n. Disaster Relief. Unless you object, we may disclose your PHI to agencies assisting in disaster relief.

3. Disclosures Requiring Written Authorization. Except as above, we will not use or disclose your PHI without your written authorization. This includes psychotherapy notes, disclosures for marketing, sale of PHI, etc. You have the right to revoke your authorization in writing, except to the extent we have already acted in reliance on it.

4. Your Rights Regarding PHI. You have the right to:
a. Receive a paper copy of this Notice upon request.
b. Inspect and copy your PHI for as long as we maintain it. We may charge a reasonable fee for copies.
c. Request restrictions on how your PHI is used or disclosed (for treatment, payment, operations). We are not required to accept all restrictions.
d. Request an amendment of your PHI if you believe it’s incorrect or incomplete. We may deny the request under certain conditions.
e. Receive an accounting of disclosures of your PHI (for certain types of disclosures) made in the past six years.
f. Request confidential communications by alternative means or at alternative locations (for example, contact you at home rather than work).
g. If you are seeking reproductive health care: we will not use/disclose your PHI to investigate or impose liability for the mere act of seeking reproductive health care that is lawfully provided under the conditions described.

5. Changes to this Notice. We reserve the right to change this Notice at any time. The new notice will be effective for all PHI we maintain. When changes are made, we will make the revised notice available upon request and on our website.

6. Acknowledgment of Receipt of Notice. We will ask you to sign an acknowledgment that you received this Notice.

7. Questions and Complaints. If you have questions or believe your privacy rights have been violated, you may contact:
Privacy Officer
Eye Physicians & Surgeons of Arizona
Address: 6677 W Thunderbird Road, Bldg F Ste 101, Glendale, AZ 85306
Phone: (623)878-3939
Email: [email protected]

You also may file a written complaint with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

8. Electronic Notice. You acknowledge that we may provide this Notice, and any notification of a breach of unsecured PHI, to you electronically (to the email address you provide).