Allensworth Eyecare

HIPAA Notice: Your Information. Your Rights. Our Responsibilities.

This notice describes how your medical information may be used and disclosed.

Your Rights:

· If requested Allensworth Eyecare will provide you with a copy of your medical records. Please allow 5 business days for us to get those ready for you. We will never charge you for your medical records. 

· You can request that we correct health information on your medical records that may be incorrect or incomplete. After reviewing your request we may determine that the information cannot be changed. You will be notified within 30 days if your request is denied.

· You can request confidential communication such as contacting at a certain phone number or sending mail to a different address.

· Since we do not bill to your insurance we will not share your information with your insurance provider, unless required by law. If you file for out of network reimbursement your insurance company will receive the procedure codes and diagnostic codes deemed appropriate from the examination. 

· You can ask for a list of the instances in which we have shared your health information for six years prior to the date you ask, who we shared it with, and why.

· You can receive a copy of this notice at any time, and it is also available on our website.

· You can designate someone to act for you (i.e. representative with medical power of attorney or legal guardian).

· You can file a complaint at https://www.hhs.gov/hipaa/filing-a-complaint/index.htmlor by sending a letter to 200 Independence Avenue, S.W., Washington D.C. 20201 or by calling 1-877-696-6775 if you feel that your rights have been violated. We will not retaliate against you for filing a complaint. 

· We will never include your information or photos in any marketing or fundraising material without express written permission from you or your medical representative. 

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 there has been a security breach in which the privacy or security of your personal information was compromised. 

· We must follow the duties and privacy practices described in this notice and make a copy available to you.

· We will not use or share your information other than as described in this notice unless you tell us we can in writing. If you change your mind and would no longer like us to use your information simply submit a new request in writing. 

· Instances where we may share your health information:

     o We may share your information with other healthcare professional who are treating you.

     o We may use your information to run our practice, improve your care, or contact you when necessary. 

     o We may report suspected abuse, neglect, or domestic violence to reduce or prevent a serious threat to            anyone’s health or safety.

     o We do not conduct research at this office and will not use your health information for such unless we obtain written permission or if we are issued a subpoena. 

     o We will comply with the law and provide your information if needed for workers’ compensation, law enforcement, and/or other government requests. 

We may change the terms of this notice, and the changes will apply to your information. The new notice will be made available to you by requesting in office, and will also be updated on our website. 

Effective as of 06/01/2026

Privacy Official: Cash Allensworth

admin@allensworthec.com

Texting Policy:

- We have made texting available for easier communication with our office.

- Feel free to text (405)252-1517 with any questions or appointment requests. They will be answered by Dr. Allensworth or the receptionist. You may also call the same number if you prefer.

- You will only receive texts from our office for appointment reminders, notifications that glasses and/or contacts are ready for pickup, to remind you of an outstanding balance, or in response to a direct question that you have texted us.

- We will not send any promotional or marketing texts. 

- You can opt out of text communications at any point. Simply let us know that you prefer communication to be via calls only.