ZEIGLER FAMILY EYE CARE
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), We 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, Tim
Zeigler, OD, can 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 you to provide  
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: Dr.Tim Zeigler, OD, 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 Timothy J. Zeigler, OD, PA privacy
policies, please contact Dr. Zeigler, Optometrist, at the following address or phone number:
Timothy J. Zeigler OD, PA, 1819 S. University Drive, Davie, Florida 33324, 954-577-7272.
PRIVACY NOTICE