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. Purpose and Scope
This Privacy Policy and Notice of Privacy Practices (“Notice”) applies to Dearborn EyeCare (“we,” “us,” or “our”), an optometry practice providing eye examinations, diagnosis and treatment, vision-related health care, optical services, and related administrative services. It applies to protected health information (“PHI”) created, received, maintained, or transmitted by the practice in paper, electronic, oral, photographic, or other forms.
This Notice is intended to satisfy the federal HIPAA Privacy Rule notice requirements and to describe additional privacy practices applicable to our website, electronic communications, and patient information. Where federal or Michigan law provides a more protective privacy right, we will comply with the applicable law.
2. Our Legal Duties
- We are required by law to maintain the privacy and security of PHI, provide you with this Notice describing our legal duties and privacy practices, and notify affected individuals following a breach of unsecured PHI when required by law.
- We will follow the terms of the Notice currently in effect.
- We reserve the right to change this Notice. If we materially change our privacy practices, we will revise the Notice and make the revised Notice available as required by law.
3. How We May Use and Disclose PHI Without Your Separate Written AuthorizationTreatmentWe may use or disclose PHI to provide, coordinate, or manage your eye care and related health care. Examples include sharing relevant information with another health care professional involved in your care, communicating with a laboratory or optical vendor when necessary to fulfill an order, or coordinating referrals.
Payment
We may use or disclose PHI to obtain payment for services. Examples include submitting claims to health plans, verifying eligibility and benefits, obtaining prior authorization when applicable, and responding to payment-related inquiries.
Health Care Operations
We may use or disclose PHI for health care operations, including quality assessment, staff training, credentialing, compliance activities, auditing, billing administration, practice management, business planning, and other activities permitted by HIPAA.
Other Permitted or Required Uses and Disclosures
- As required by federal, state, or local law.
- For public health activities permitted by law, such as reporting certain diseases or adverse events.
- To report suspected abuse, neglect, or domestic violence when legally required or permitted.
- For health oversight activities, audits, investigations, inspections, licensure, and disciplinary proceedings as authorized by law.
- For judicial and administrative proceedings when the applicable legal requirements are satisfied.
- For law enforcement purposes when permitted or required by applicable law.
- To coroners, medical examiners, or funeral directors when permitted by law.
- For organ, eye, or tissue donation and transplantation purposes when legally applicable.
- For research when the applicable legal requirements are satisfied.
- To prevent or lessen a serious and imminent threat to health or safety when permitted by law.
- For workers’ compensation or similar programs as authorized by law.
- For specialized government functions, military or veterans’ activities, national security, protective services, and correctional institutions when applicable.
- To business associates that perform services for us, but only under applicable HIPAA requirements and written agreements where required.
4. Uses and Disclosures Requiring Your Authorization
Except where otherwise permitted or required by law, we will obtain your written authorization before using or disclosing PHI for purposes that require authorization under HIPAA, including most uses and disclosures of psychotherapy notes, certain marketing activities, and any sale of PHI. An authorization may be revoked in writing to the extent permitted by law, but revocation will not affect actions already taken in reliance on the authorization.
We will not condition treatment, payment, enrollment, or eligibility for benefits on your signing an authorization except where HIPAA expressly permits such a condition.
5. Communications With You
We may contact you using the contact information you provide to us for treatment, payment, health care operations, appointment scheduling, reminders, care coordination, prescription or eyewear notifications, and other communications permitted by law. Depending on your preferences and the communication, this may include telephone calls, voicemail, postal mail, email, patient portals, text messaging, and other electronic communications.
We use reasonable safeguards designed to reduce the risk of an unintended disclosure. For example, we may limit the amount of PHI included in voicemail, email, or text messages, verify contact information when appropriate, and avoid including unnecessary clinical details in ordinary text messages.
You may request confidential communications by a particular means or at a particular location. We will accommodate reasonable requests as required by HIPAA and applicable law.
6. Your HIPAA Privacy Rights
- Right to Inspect and Obtain a Copy. You generally have the right to inspect or obtain a copy of PHI in designated record sets, subject to limited legal exceptions. We may charge a permitted cost-based fee.
- Right to Request Amendment. You may request correction of PHI you believe is inaccurate or incomplete. We may deny a request in circumstances permitted by law and will provide a written response.
- Right to Request Restrictions. You may request restrictions on certain uses or disclosures of PHI. We are not generally required to agree, except where HIPAA requires acceptance of a restriction concerning a service paid in full out of pocket and the restriction otherwise qualifies.
- Right to Confidential Communications. You may request that we communicate with you by an alternative means or at an alternative location.
- Right to an Accounting of Disclosures. You may request an accounting of certain disclosures of PHI made during the six years before your request, subject to HIPAA exceptions.
- Right to a Paper Copy. You may request a paper copy of this Notice even if you agreed to receive it electronically.
- Right to Choose a Personal Representative. An authorized personal representative may exercise rights on your behalf when legally permitted.
- Right to Complain. You may complain to us or to the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.
7. Special Rules for Certain Information
Certain categories of information may receive heightened protection under federal or Michigan law. Where a specific law imposes additional requirements, we will comply with those requirements. This may include information relating to substance use disorder treatment records, psychotherapy notes, HIV/AIDS, genetic information, reproductive health care, minors’ records, or other specially protected information when applicable.
Nothing in this Notice is intended to waive or reduce any privacy protection that applies to information under federal or Michigan law.
8. Michigan Medical Records and Patient Access
Michigan law provides patients and authorized representatives rights to inspect or obtain medical records, subject to applicable exceptions and procedures. Michigan law also requires licensed health professionals to maintain records in a manner that protects their integrity, confidentiality, proper use, and accessibility. We will process record requests in accordance with applicable federal and Michigan requirements.
Record requests should be directed to the practice using the contact information at the end of this Notice. Identity and authority will be verified before records are released.
9. Family Members, Friends, and Other Persons Involved in Your Care
When permitted by HIPAA, we may disclose relevant information to a family member, close personal friend, or other person identified by you as being involved in your care or payment for care, unless you object or another legal restriction applies. We may use professional judgment to determine whether a disclosure is appropriate in the circumstances.
10. Minors and Personal Representatives
We will apply applicable federal and Michigan rules concerning minors, parents, guardians, personal representatives, and individuals who may exercise a patient’s rights. Because Michigan law contains circumstances in which a minor may have specific rights concerning particular health care, the practice will evaluate authority and access requests on a case-by-case basis.
11. Website and Online Privacy
Our website, www.Dearborneyes.com, may collect information voluntarily submitted through contact, appointment, or other online forms, as well as technical information such as browser/device information, IP address, cookies, and usage information depending on the services used on the site.
We will use information collected through the website for the purposes for which it was submitted, to operate and secure the website, respond to inquiries, provide requested services, improve the site, and for other purposes permitted by law. Website information that identifies an individual and relates to health care may constitute PHI when maintained by the practice in its covered-entity systems.
Do not use ordinary website forms, email, or text messaging to send urgent medical information or emergency requests. If you are experiencing an emergency, call 911 or seek immediate emergency care.
12. Cookies, Analytics, and Third-Party Services
We may use cookies, analytics, scheduling, communications, payment, hosting, security, or other third-party technologies. Where a vendor creates, receives, maintains, or transmits PHI on our behalf, we will use appropriate contractual and HIPAA safeguards when required. Non-HIPAA website technologies may be subject to their own privacy policies and terms. We will not knowingly configure third-party tools to disclose PHI for purposes prohibited by law.
If our website uses advertising, analytics, pixels, or similar tracking technologies, those technologies must be reviewed and configured separately for HIPAA compliance before being used with pages or workflows involving PHI.
13. Marketing and Sale of PHI
We will not use or disclose PHI for marketing when HIPAA requires your authorization unless you provide the required authorization. We will not sell PHI except as permitted by law and with any authorization required by HIPAA.
14. Security and Breach Notification
We maintain administrative, physical, and technical safeguards designed to protect PHI against unauthorized access, use, disclosure, alteration, and destruction. No method of electronic transmission or storage is completely risk-free.
If a breach of unsecured PHI occurs that requires notification under HIPAA, we will provide notification in accordance with applicable federal law. We will also comply with applicable Michigan data-breach and security requirements.
15. Complaints and Privacy Contact
If you have questions, concerns, or complaints about our privacy practices, contact Dearborn EyeCare at 32788 Five Mile Rd, Suite 3, Livonia, MI 48154, phone 313-722-4702, fax 313-722-4743, or email management@dearborneyes.com. You may also contact the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a privacy complaint.
OCR HIPAA complaint information is available through the U.S. Department of Health and Human Services website.
16. Effective Date and Acknowledgment
Effective date: September 10, 2026. This Notice remains effective until replaced by a revised Notice. We will request an acknowledgment of receipt as required by HIPAA. Your signature acknowledging receipt does not constitute an authorization to use or disclose PHI beyond what is described in this Notice.
17. Important Implementation Note
This document is designed as a comprehensive practice template and should be reviewed by the practice’s HIPAA/privacy counsel before adoption. The practice should also maintain separate internal policies for HIPAA security, breach response, business associate management, records retention/destruction, workforce training, patient identity verification, website tracking technologies, and authorization forms.
Primary legal references used in preparing this template:
HIPAA Privacy Rule, 45 CFR Part 164, including §§ 164.502, 164.508, 164.510, 164.512, 164.520, 164.522, 164.524, 164.526, 164.528, and 164.530; Michigan Medical Records Access Act, MCL 333.26265; Michigan Public Health Code record-confidentiality requirements, including MCL 333.16213; and other applicable federal and Michigan privacy/security laws
