Notice of Privacy Practices

This Notice of Privacy Practices is provided from Comfort Vision Inc for educational and informational purposes
only. This Notice is not intended as legal advice, and is not provided for adoption or publication by any party.
The publication of any such notice may create legal obligations or liabilities which may vary depending upon the
legal status and business operations of different organizations. The form and content of any Notice of Privacy
Practices should be determined only upon informed consultation with qualified legal counsel.

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.

THIS NOTICE IS EFFECTIVE 04/19/07 UNTIL FURTHER NOTICE.

Right to Notice As a patient, you have the right to adequate notice of the uses and disclosures of your
protected health information. Under the Health Insurance Portability and Accessibility Act (HIPAA), Comfort
Vision Inc can use your protected health information for treatment, payment and health care operations.
a) Treatment - We may use or disclose your health information to a physician or other healthcare provider
providing treatment to you.
b) Payment - We may use and disclose your health information to obtain payment for services we provide you.
c) Health care operations - We may use and disclose your health information in connection with our healthcare
operations. Healthcare operations include quality assessment and improvement activities, reviewing the
competency or qualifications of healthcare professionals, evaluating provider performance, conducting training
programs, accreditation, certification, licensing or credentialing activities.

Your Authorization Most uses and disclosures that do not fall under treatment, payment, health care operations
will require your written authorization. Upon signing, you may revoke your authorization (in writing) through our
practice at any time.

Emergency Situations In the event of your incapacity or an emergency situation, we will disclose health
information to a family member, or another person responsible for your care, using our professional judgment.
We will only disclose health information that is directly relevant to the person's involvement in your healthcare.

Marketing We will not use your health information for marketing communications without your written
authorization.

Required by Law We may also use or disclose your health information when we are required to do so by law.

Abuse or Neglect We may disclose your health information to appropriate authorities if we reasonably believe
that you are a possible victim of abuse, neglect, or domestic violence or the victim of other crimes. We may
disclose your health information to the extent necessary to avert a serious threat to your or other people's
health or safety.

National Security We may disclose the health information of Armed Forces personnel to military authorities
under certain circumstances. We may disclose health information to authorized federal officials required for
lawful intelligence, counterintelligence and other national security activities. We may disclose health information
of inmates or patients to the appropriate authorities under certain circumstances.

Appointment Reminders We may use or disclose your health information to provide you with appointment
reminders via phone, e-mail or letter.

Your Rights as a Patient You have the right to restrict the disclosure of your protected health information (in
writing). The request for restriction may be denied if the information is required for treatment, payment or health
care operations. -You have the right to receive confidential communications regarding your protected health
information. -You have the right to inspect and copy your protected health information. -You have the right to
amend your protected health information. -You have the right to receive an account of disclosures of your
protected health information. -You have the right to a paper copy of this notice of privacy practices.

Legal Requirements
Comfort Vision Inc is required by law to maintain the privacy of your protected health information. We are
required to abide by the terms of this notice as it is currently stated, and reserve the right to change this notice.
The policies in any new notice will not be in effect until they are posted to this site, or are available within our
office.

Complaints If you have complaints regarding the way your protected health information was handled, you may
submit a complaint in writing to our office. You will not be retaliated against in any manner for a complaint.

Contact Information
For further information about Comfort Vision Inc privacy policies, please contact Dr. Trung Bui at the following
address or phone number:
Comfort Vision Inc
221 Quincy Ave, Unit B, Quincy MA 02169
Ph: (617) 657-0205
F: (617) 657-0206
Email: icomfortvision@yahoo.com