NOTICE OF PRIVACY PRACTICES
While Pacific ClearVision Institute has always adhered to State and Federal law in regards to our patients privacy and their rights, the following updatyed practices are effective as of February 16, 2026.
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.
We take our responsibility to safeguard your protected health information very seriously. We value your trust
as an important part of our ability to provide you with the best possible medical care. We are dedicated to
defending your right to a confidential relationship with your provider.
This notice describes how your medical information may be used and disclosed and how you can access this
information. Please review it carefully.
How We May Use and Disclose Your Information
We may use and disclose health information about you without your permission for the following reasons:
1. For Treatment: To coordinate or manage your care with other providers or facilities.
2. For Payment: To obtain reimbursement from insurance for services provided.
3. For Healthcare Operations: To improve our services, manage our practice, train staff, and perform
audits.
4. For Legal Requirements: When required by federal, state, or local law.
5. To Prevent Serious Threats: To protect your health and safety or the health and safety of others.
6. For Public Health and Safety: Including disease prevention, abuse reporting, and FDA oversight.
7. For Research: When reviewed and approved under a special process.
8. For Workers’ Compensation and Law Enforcement: When required under these programs.
9. With Family or Friends: If involved in your care and based on your preference or best interest.
We will only share the minimum necessary information needed for each purpose.
We will not use or disclose your health information for marketing, sale, or fundraising without your written
authorization. You may revoke this authorization at any time in writing.
Special Protections: Substance Use Disorder (SUD) Records
If your medical record includes information related to substance use disorder treatment protected under
federal law (42 CFR Part 2), that information has additional privacy protections:
• We will not disclose it without your written consent unless required by law.
• It may not be used in court or legal proceedings without a special court order.
• You may revoke your consent at any time.
• Any re-disclosure of this information by others may no longer be protected.
• You have the right to opt out of any fundraising communications.
Your Rights
You have the right to:
• Access: Ask to see or get a copy of your health and billing records.
• Amend: Ask us to correct your records if you think they’re incorrect.
• Request Restrictions: Ask us not to use or share certain information. We are not required to agree
but will consider your request.
• Request Confidential Communications: Ask us to contact you in a specific way (e.g., only at
work, no voicemail).
• Accounting of Disclosures: Ask for a list of when we shared your information for reasons other
than treatment, payment, or healthcare operations.
• Get a Copy of This Notice: You can request a paper copy at any time.
• Be Notified of a Breach: You will be notified if a breach occurs that may have compromised your
protected health information.
To exercise any of these rights, contact our Privacy Officer using the contact details at the top of this page.
Our Responsibilities
We are required by law to:
• Keep your health information private.
• Provide you with this Notice.
• Follow the terms of this Notice.
• Notify you if a breach of your protected information occurs.
We may change our privacy practices and update this Notice. If we do, the new terms will apply to all health
information we maintain. We will post the updated Notice in our office and on our website, and make copies
available upon request.
Complaints and Questions
If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S.
Department of Health and Human Services. You will not be retaliated against for filing a complaint.
Contact for complaints or more information:
Privacy Officer
Pacific ClearVision Institute
Eugene, OR 97401
(541)-343-5000
We are committed to earning and maintaining your trust by protecting your health information with care and
respect.
