NOTICE OF PRIVACY PRACTICES
Yukon Eye Care | Notice of Privacy Practices
Last Updated: 01/26/2026
Your Information. Your Rights. Our Responsibilities.
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.
Your Rights
When it comes to your health information, you have certain
rights. This section explains your rights and some of our
responsibilities to help you.
GET AN ELECTRONIC OR PAPER COPY OF YOUR MEDICAL
RECORD
● You can ask to see or get an electronic or paper copy of
your medical record and other health information we
have about you. Ask us how to do this.
● We will provide a copy or a summary of your health
information. We may charge a reasonable, cost-based
fee.
ASK US TO CORRECT YOUR MEDICAL RECORD
● You can ask us to correct health information about you
that you think is incorrect or incomplete. Ask us how to
do this.
● We may say “no” to your request, but we’ll tell you why in
writing within 60 days
REQUEST CONFIDENTIAL COMMUNICATIONS
● You can ask us to contact you in a specific way (for
example, home or office phone) or to send mail to a
different address.
● We will say “yes” to all reasonable requests.
ASK US TO LIMIT WHAT WE USE OR SHARE
● You can ask us not to use or share certain health
information for treatment, payment, or our operations.
We are not required to agree to your request, and we may
say “no” if it would affect your care.
● If you pay for a service or health care item out-of-pocket
in full, you can ask us not to share that information for
the purpose of payment or our operations with your
health insurer. We will say “yes” unless a law requires us
to share that information.
GET A LIST OF THOSE WITH WHOM WE’VE SHARED
INFORMATION
● You can ask for a list (accounting) of the times we’ve
shared your health information for six years prior to the
date you ask, who we shared it with, and why.
● We will include all the disclosures except for those about
treatment, payment, and health care operations, and
certain other disclosures (such as any you asked us to
make). We’ll provide one accounting a year for free but
will charge a reasonable, cost-based fee if you ask for
another one within 12 months.
GET A COPY OF THIS PRIVACY NOTICE
● You can ask for a paper copy of this notice at any time,
even if you have agreed to receive the notice
electronically. We will provide you with a paper copy
promptly.
CHOOSE SOMEONE TO ACT FOR YOU
● If you have given someone medical power of attorney or
if someone is your legal guardian, that person can
exercise your rights and make choices about your health
information.
● We will make sure the person has this authority and can
act for you before we take any action.
FILE A COMPLAINT IF YOU FEEL YOUR RIGHTS ARE
VIOLATED
● You can complain if you feel we have violated your rights
by contacting us at 405-354-2788.
● You can file a complaint with the U.S. Department of
Health and Human Services Office for Civil Rights by
sending a letter to 200 Independence Avenue, S.W.,
Washington, D.C. 20201, calling 1-877-696-6775, or
visiting www.hhs.gov/ocr/privacy/hipaa/complaints
● We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices
about what we share. If you have a clear preference for how
we share your information in the situations described below,
talk to us. Tell us what you want us to do, and we will follow
your instructions.
In these cases, you have both the right and choice to tell us
to:
● Share information with your family, close friends, or
others involved in your care
● Share information in a disaster relief situation
● Include your information in a hospital directory
If you are not able to tell us your preference, for example if
you are unconscious, we may go ahead and share your
information if we believe it is in your best interest. We may
also share your information when needed to lessen a
serious and imminent threat to health or safety.
In these cases we never share your information unless you
give us written permission:
Yukon Eye Care Page 1
● Marketing purposes
● Sale of your information
● Most sharing of psychotherapy notes
In the case of fundraising:
● We may contact you for fundraising efforts, but you can
tell us not to contact you again.
● If we intend to use or disclose your substance use
disorder records (subject to 42 CFR Part 2) for
fundraising purposes, you have the right to elect not to
receive such communications before we send them.
Our Uses and Disclosures
HOW DO WE TYPICALLY USE OR SHARE YOUR HEALTH
INFORMATION?
We typically use or share your health information in the
following ways:
TREAT YOU
We can use your health information and share it with other
professionals who are treating you.
Example: A doctor treating you for an injury asks another
doctor about your overall health condition.
RUN OUR ORGANIZATION
We can use and share your health information to run our
practice, improve your care, and contact you when
necessary.
Example: We use health information about you to manage
your treatment and services.
BILL FOR YOUR SERVICES
We can use and share your health information to bill and get
payment from health plans or other entities.
Example: We give information about you to your health
insurance plan so it will pay for your services.
HOW ELSE CAN WE USE OR SHARE YOUR HEALTH
INFORMATION?
We are allowed or required to share your information in other
ways – usually in ways that contribute to the public good,
such as public health and research. We have to meet many
conditions in the law before we can share your information
for these purposes. For more information see:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/
index.html
SUBSTANCE USE DISORDER RECORDS (42 CFR PART 2)
● Use and Disclosure: We may use and disclose your
substance use disorder records subject to 42 CFR Part 2
for treatment, payment, and health care operations as
permitted by law.
● Prohibition on Use in Legal Proceedings: We are
prohibited from using or disclosing your substance use
disorder records subject to 42 CFR Part 2 in any civil,
criminal, administrative, or legislative proceedings
against you without your specific written consent or a
court order.
HELP WITH PUBLIC HEALTH AND SAFETY ISSUES
We can share health information about you for certain
situations such as:
● Preventing disease
● Helping with product recalls
● Reporting adverse reactions to medications
● Reporting suspected abuse, neglect, or domestic
violence
● Preventing or reducing a serious threat to anyone’s
health or safety
DO RESEARCH
We can use or share your information for health research.
COMPLY WITH THE LAW
We will share information about you if state or federal laws
require it, including with the Department of Health and
Human Services if it wants to see that we’re complying with
federal privacy law.
RESPOND TO ORGAN AND TISSUE DONATION REQUESTS
We can share health information about you with organ
procurement organizations.
WORK WITH A MEDICAL EXAMINER OR FUNERAL
DIRECTOR
We can share health information with a coroner, medical
examiner, or funeral director when an individual dies.
ADDRESS WORKERS’ COMPENSATION, LAW
ENFORCEMENT, AND OTHER GOVERNMENT REQUESTS
We can use or share health information about you:
● For workers’ compensation claims
● For law enforcement purposes or with a law enforcement
official
● With health oversight agencies for activities authorized
by law
● For special government functions such as military,
national security, and presidential protective services
RESPOND TO LAWSUITS AND LEGAL ACTIONS
We can share health information about you in response to a
court or administrative order, or in response to a subpoena.
Our Responsibilities
● We are required by law to maintain the privacy and
security of your protected health information.
● We will let you know promptly if a breach occurs that
may have compromised the privacy or security of your
information.
● We must follow the duties and privacy practices
described in this notice and give you a copy of it.
● We will not use or share your information other than as
described here unless you tell us we can in writing. If you
Yukon Eye Care Page 2
Yukon Eye Care | Notice of Privacy Practices
Last Updated: 01/26/2026
tell us we can, you may change your mind at any time.
Let us know in writing if you change your mind.
FOR MORE INFORMATION SEE:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/
noticepp.html
CHANGES TO THE TERMS OF THIS NOTICE
We can change the terms of this notice, and the changes will
apply to all information we have about you. The new notice
will be available upon request, in our office, and on our
website.
Last Updated: 01/26/2026
Your Information. Your Rights. Our Responsibilities.
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.
Your Rights
When it comes to your health information, you have certain
rights. This section explains your rights and some of our
responsibilities to help you.
GET AN ELECTRONIC OR PAPER COPY OF YOUR MEDICAL
RECORD
● You can ask to see or get an electronic or paper copy of
your medical record and other health information we
have about you. Ask us how to do this.
● We will provide a copy or a summary of your health
information. We may charge a reasonable, cost-based
fee.
ASK US TO CORRECT YOUR MEDICAL RECORD
● You can ask us to correct health information about you
that you think is incorrect or incomplete. Ask us how to
do this.
● We may say “no” to your request, but we’ll tell you why in
writing within 60 days
REQUEST CONFIDENTIAL COMMUNICATIONS
● You can ask us to contact you in a specific way (for
example, home or office phone) or to send mail to a
different address.
● We will say “yes” to all reasonable requests.
ASK US TO LIMIT WHAT WE USE OR SHARE
● You can ask us not to use or share certain health
information for treatment, payment, or our operations.
We are not required to agree to your request, and we may
say “no” if it would affect your care.
● If you pay for a service or health care item out-of-pocket
in full, you can ask us not to share that information for
the purpose of payment or our operations with your
health insurer. We will say “yes” unless a law requires us
to share that information.
GET A LIST OF THOSE WITH WHOM WE’VE SHARED
INFORMATION
● You can ask for a list (accounting) of the times we’ve
shared your health information for six years prior to the
date you ask, who we shared it with, and why.
● We will include all the disclosures except for those about
treatment, payment, and health care operations, and
certain other disclosures (such as any you asked us to
make). We’ll provide one accounting a year for free but
will charge a reasonable, cost-based fee if you ask for
another one within 12 months.
GET A COPY OF THIS PRIVACY NOTICE
● You can ask for a paper copy of this notice at any time,
even if you have agreed to receive the notice
electronically. We will provide you with a paper copy
promptly.
CHOOSE SOMEONE TO ACT FOR YOU
● If you have given someone medical power of attorney or
if someone is your legal guardian, that person can
exercise your rights and make choices about your health
information.
● We will make sure the person has this authority and can
act for you before we take any action.
FILE A COMPLAINT IF YOU FEEL YOUR RIGHTS ARE
VIOLATED
● You can complain if you feel we have violated your rights
by contacting us at 405-354-2788.
● You can file a complaint with the U.S. Department of
Health and Human Services Office for Civil Rights by
sending a letter to 200 Independence Avenue, S.W.,
Washington, D.C. 20201, calling 1-877-696-6775, or
visiting www.hhs.gov/ocr/privacy/hipaa/complaints
● We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices
about what we share. If you have a clear preference for how
we share your information in the situations described below,
talk to us. Tell us what you want us to do, and we will follow
your instructions.
In these cases, you have both the right and choice to tell us
to:
● Share information with your family, close friends, or
others involved in your care
● Share information in a disaster relief situation
● Include your information in a hospital directory
If you are not able to tell us your preference, for example if
you are unconscious, we may go ahead and share your
information if we believe it is in your best interest. We may
also share your information when needed to lessen a
serious and imminent threat to health or safety.
In these cases we never share your information unless you
give us written permission:
Yukon Eye Care Page 1
● Marketing purposes
● Sale of your information
● Most sharing of psychotherapy notes
In the case of fundraising:
● We may contact you for fundraising efforts, but you can
tell us not to contact you again.
● If we intend to use or disclose your substance use
disorder records (subject to 42 CFR Part 2) for
fundraising purposes, you have the right to elect not to
receive such communications before we send them.
Our Uses and Disclosures
HOW DO WE TYPICALLY USE OR SHARE YOUR HEALTH
INFORMATION?
We typically use or share your health information in the
following ways:
TREAT YOU
We can use your health information and share it with other
professionals who are treating you.
Example: A doctor treating you for an injury asks another
doctor about your overall health condition.
RUN OUR ORGANIZATION
We can use and share your health information to run our
practice, improve your care, and contact you when
necessary.
Example: We use health information about you to manage
your treatment and services.
BILL FOR YOUR SERVICES
We can use and share your health information to bill and get
payment from health plans or other entities.
Example: We give information about you to your health
insurance plan so it will pay for your services.
HOW ELSE CAN WE USE OR SHARE YOUR HEALTH
INFORMATION?
We are allowed or required to share your information in other
ways – usually in ways that contribute to the public good,
such as public health and research. We have to meet many
conditions in the law before we can share your information
for these purposes. For more information see:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/
index.html
SUBSTANCE USE DISORDER RECORDS (42 CFR PART 2)
● Use and Disclosure: We may use and disclose your
substance use disorder records subject to 42 CFR Part 2
for treatment, payment, and health care operations as
permitted by law.
● Prohibition on Use in Legal Proceedings: We are
prohibited from using or disclosing your substance use
disorder records subject to 42 CFR Part 2 in any civil,
criminal, administrative, or legislative proceedings
against you without your specific written consent or a
court order.
HELP WITH PUBLIC HEALTH AND SAFETY ISSUES
We can share health information about you for certain
situations such as:
● Preventing disease
● Helping with product recalls
● Reporting adverse reactions to medications
● Reporting suspected abuse, neglect, or domestic
violence
● Preventing or reducing a serious threat to anyone’s
health or safety
DO RESEARCH
We can use or share your information for health research.
COMPLY WITH THE LAW
We will share information about you if state or federal laws
require it, including with the Department of Health and
Human Services if it wants to see that we’re complying with
federal privacy law.
RESPOND TO ORGAN AND TISSUE DONATION REQUESTS
We can share health information about you with organ
procurement organizations.
WORK WITH A MEDICAL EXAMINER OR FUNERAL
DIRECTOR
We can share health information with a coroner, medical
examiner, or funeral director when an individual dies.
ADDRESS WORKERS’ COMPENSATION, LAW
ENFORCEMENT, AND OTHER GOVERNMENT REQUESTS
We can use or share health information about you:
● For workers’ compensation claims
● For law enforcement purposes or with a law enforcement
official
● With health oversight agencies for activities authorized
by law
● For special government functions such as military,
national security, and presidential protective services
RESPOND TO LAWSUITS AND LEGAL ACTIONS
We can share health information about you in response to a
court or administrative order, or in response to a subpoena.
Our Responsibilities
● We are required by law to maintain the privacy and
security of your protected health information.
● We will let you know promptly if a breach occurs that
may have compromised the privacy or security of your
information.
● We must follow the duties and privacy practices
described in this notice and give you a copy of it.
● We will not use or share your information other than as
described here unless you tell us we can in writing. If you
Yukon Eye Care Page 2
Yukon Eye Care | Notice of Privacy Practices
Last Updated: 01/26/2026
tell us we can, you may change your mind at any time.
Let us know in writing if you change your mind.
FOR MORE INFORMATION SEE:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/
noticepp.html
CHANGES TO THE TERMS OF THIS NOTICE
We can change the terms of this notice, and the changes will
apply to all information we have about you. The new notice
will be available upon request, in our office, and on our
website.