Welcome Brochure

believe that the information we have about you is incomplete or incorrect. Your request for an amendment must explain why you feel an amendment is necessary. Under certain circumstances, we may deny your request. If we do so, we will provide you with a written explanation as to why the request was denied. Right to Receive an Accounting of Disclosures: You have the right to obtain a listing of those persons or organizations who received your health information from us. The listing will not cover health related information that was disclosed to you, information disclosed for treatment, payment or health care operations, or information used to conduct routine UEC operations. Right to Notice in the Event of a Breach: You have the right to be notified when your PHI has been acquired, accessed, used or disclosed in a manner that is not legally permitted, and where we determine that your PHI has potentially been compromised (“breached”). If a breach of your PHI occurs, you will be notified of the breach in writing, within 60 days of the date when the breach was discovered. Right to a Paper Copy of this Notice of Privacy Practices (NPP): You may obtain a copy of the current NPP by downloading a copy from our website at UniversityEyeCenter.org , by asking a member of our staff, or by calling us at (212) 938-4001. If you have questions about any part of this notice or would like to discuss our privacy practices, please contact us at SUNY College of Optometry, University Eye Center, ATTN: Clinical Administration, 33 West 42nd Street, New York, New York 10036 or by calling us (212) 938-4030. Complaints If you believe your privacy rights have been violated, you may file a complaint with us by emailing compliance@sunyopt.edu , calling the confidential hotline at (888) 906-6777, or by writing to the following address: Privacy Officer, SUNY College of Optometry, University Eye Center, ATTN: Clinical Administration, 33 West 42nd Street, New York, New York 10036. You may also file a complaint with the Office for Civil Rights of the U.S. Department of Health and Human Services. You will not be penalized for filing a complaint.

16 UNIVERSITY EYE CENTER

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