Effective date: September 8, 2026
Privacy contact: Legal Department
Telephone: (718) 261-6000
Mail: Forest Hills Vision Associates, Inc., Attention: Legal Department, 69-39 Austin Street, Forest Hills, NY 11375
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.
About this notice
This notice describes the privacy practices of Forest Hills Vision Associates, Inc. and its workforce when handling your protected health information. It covers information maintained for your care and related practice activities, in paper, electronic, and other forms. The website’s separate privacy notice explains ordinary website use.
Your rights and how to use them
Contact the privacy contact above for help exercising these rights. You may send a written request to the office address. We may verify your identity or authority before releasing information. You do not need a website account to request help.
See or obtain your records. You may request access to medical and billing information we maintain about you, including paper or electronic copies in an available format. We will respond within applicable legal time limits. Where New York’s records-inspection requirement applies, we will offer an opportunity to inspect within 10 days after receiving your written request. Copy requests are subject to applicable federal and state rules. Any permitted copying fee will be reasonable and comply with those rules. If access is denied, we will provide the reason and explain any available review or appeal rights.
Request a correction. You may ask us in writing to amend information you believe is inaccurate or incomplete and explain why. We may deny a request where the law permits, but will explain the denial in writing and how you may submit a statement of disagreement.
Request private communications. You may ask us to contact you at a different address, telephone number, or by another reasonable method. Tell us the method or location you prefer. We will accommodate reasonable requests.
Ask us to limit sharing. You may request limits on information used or shared for treatment, payment, or practice operations. We generally do not have to agree to a requested restriction. However, if you pay in full out of pocket for an item or service and request that we not disclose related information to your health plan for payment or health care operations, we must honor that restriction unless disclosure is required by law. Tell us before the information is sent to the plan.
Request an accounting of disclosures. You may ask for a list of certain disclosures during the preceding six years. The accounting generally excludes disclosures for treatment, payment, health care operations, and other exceptions under the law. The first accounting in a 12-month period is free; we will explain any permitted charge for an additional request before proceeding.
Receive a paper notice. You may request a paper copy of this notice at any time, including if you previously accepted an electronic copy.
Use a representative. A person legally authorized to act for you may exercise rights on your behalf, subject to applicable law. We will verify that authority. Parents’ and guardians’ access to a minor’s information depends on the circumstances and applicable confidentiality laws.
How we may use and share information
We may use or disclose information without a separate written authorization for the purposes below, only as permitted or required by law. Additional protections described later in this notice may limit these permissions.
Treatment. We use information to provide and coordinate your eye care. For example, your optometrist may share examination findings with a specialist involved in your treatment.
Payment. We use information to obtain payment for services. For example, we may send your insurer information about an examination to process a claim.
Health care operations. We use information to run and improve the practice. For example, we may review care records for quality improvement. Service providers assisting with functions such as records systems or billing may receive information under arrangements required by law.
Communications about care. We may contact you about appointments, your care, treatment alternatives, or related health benefits and services as permitted by law. Tell us if you need a different contact method.
People involved in your care. We may share relevant information with family, friends, or others involved in your care or payment when you agree, have an opportunity to object and do not, or when another legal basis permits it. If you cannot express a preference, we may use professional judgment to share relevant information in your best interest. Limited information may also be shared for permitted disaster-relief purposes.
Other legally permitted or required purposes. Subject to applicable safeguards and limits, information may be used or disclosed:
- For public health activities, such as required disease reporting, product recalls, and reporting adverse reactions.
- To report abuse, neglect, or domestic violence where authorized or required by law.
- For health oversight, such as legally authorized audits, investigations, or licensing activities.
- For judicial or administrative proceedings, such as a qualifying court order or subpoena, only when the applicable conditions are met.
- For law enforcement purposes permitted by law.
- To avert a serious and imminent threat to health or safety where permitted by law.
- For organ or tissue donation and legally authorized functions of coroners, medical examiners, or funeral directors.
- For research when the required authorization, waiver, or other legal conditions are satisfied.
- For applicable workers’ compensation programs and authorized military, national-security, protective-service, or correctional functions.
- To comply with other legal requirements, including authorized review by the U.S. Department of Health and Human Services.
These permissions do not mean the practice routinely undertakes every listed activity.
Uses requiring your permission
Uses and disclosures not described in this notice require your written authorization unless otherwise permitted or required by law. Written authorization is generally required for marketing as defined by HIPAA, sale of protected health information, and most uses or disclosures of psychotherapy notes.
You may revoke an authorization in writing by contacting the privacy contact. Revocation does not undo action already taken in reliance on the authorization or affect other exceptions permitted by law.
We do not use patient information for fundraising.
Additional protections for sensitive information
When another applicable law gives your information greater protection, we follow that law. New York imposes special restrictions on confidential HIV-related information; we disclose it only with an appropriate release or another authorization provided by law. Other protections may apply to particular mental health, genetic, minor-consented, or other sensitive records. General permissions elsewhere in this notice do not override those protections.
If we receive or maintain substance use disorder patient records protected by 42 CFR Part 2, those records, or testimony revealing their content, may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without the required written consent or a qualifying court order issued after notice and an opportunity to be heard. A court order authorizing disclosure must be accompanied by a subpoena or other legal requirement compelling disclosure. We follow the additional restrictions that apply to those records.
Our responsibilities
We are required to maintain the privacy of protected health information, provide this notice of our legal duties and practices, and follow the notice currently in effect. We must notify affected individuals following a breach of unsecured protected health information as required by law.
We reserve the right to change this notice and make revised terms apply to information we already maintain as well as information received later, to the extent permitted by law. An updated notice will show its effective date and be available in the office, on our website, and upon request.
Questions or complaints
Contact the privacy contact above by telephone or mail if you have questions or believe your privacy rights have been violated. Describe the concern and how you would like us to contact you. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at hhs.gov/hipaa/filing-a-complaint, by calling 1-877-696-6775, or by writing to 200 Independence Avenue, S.W., Washington, D.C. 20201.
We will not retaliate against you for filing a complaint.
