This notice describes how medical information about you may be used and disclosed and how you can get access to this information. This notice applies to all of the records of your care generated by Soll Eye Associates, whether made by Soll Eye Associates or an associated facility. Please review it carefully.

This notice describes Soll Eye Associates' policies that extend to all of our employees.

The practice provides this Notice to comply with the privacy regulations issued by the Department of Health and Human Services in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

We are required by law to:
• make sure that the protected health information about you is kept private;
• provide you with a Notice of our Privacy Practices and your legal rights with respect to protected   health information about you; and
• follow the conditions of the Notice that is currently in effect.

We May Use and Disclose Medical Information about you for the following purposes
Medical Treatment. Medical information about you may be disclosed to doctors, nurses, technicians, medical students, or hospital personnel who are involved in taking care of you. We also may disclose medical information about you to your family members, or other personal representatives authorized by you or by a legal mandate (a guardian or other person who has been named to handle your medical decisions, should you become incompetent).
Payment. We may use and disclose medical information about you for services and procedures so they may be billed and collected from you, an insurance company, or any other third party.
Health Care Operations. We may use and disclose medical information about you so that we can run our Practice more efficiently and make sure that all of our patients receive quality care. Uses may include review and learning purposes, internal or external utilization review and/or quality assurance and billing companies.

Examples may include:
• Appointment and Patient Recall Reminders
• Emergency Situations.
• Research.
• Teaching.
• Information Disclosure Required By Law.
• To Avert a Serious Threat to Health or Safety.
• Organ and Tissue Donation.
• Recommendation of Treatment Alternatives
• Provision of Information about Health Related Benefits and Services.
• Workers' Compensation.
• Public Health Risks.
• Investigation and Government Activities.
• Lawsuits and Disputes.
• Law Enforcement.
• Inmates.
• Coroners, Medical Examiners and Funeral Directors.
• Solicitation of Funds to Benefit Soll Eye Associates.
Other uses and disclosures will be made only with the individual's authorization and the individual has the right to revoke the authorization.

You have the right to request restrictions, inspect and copy protected health information, amend or correct protected health information, and receive an accounting of disclosures of protected health information.

Soll Eye Associates retains the right to not to agree with unreasonable restrictions. Soll Eye Associates agrees to the legal requirements to protect privacy, provide notice, and adhere to the notice.

CHANGES TO THIS NOTICE
We reserve the right to change this notice at any time. Revised notices will be posted in all offices and on our website.

COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with the Practice or with the Secretary of the Department of Health and Human Services at 200 Independence Ave., S.W., Washington, DC 20201. To file a complaint with the Practice, contact our Compliance Officer, who will direct you on how to file an office complaint. All complaints must be submitted in writing, and all complaints shall be investigated, without repercussion to you.

The following personnel (James V. Capone, Privacy and Security Officer or Susan Caggiano, Compliance Officer) can be reached at this number, 215-288-5000. You will not be penalized for filing a complaint. If you have received this notice electronically, you may request a paper copy.

This authorization will remain in effect from the date of this authorization until April, 2013.