Privacy Policies

OPHTHALMOLOGY ASSOCIATES

Notice of Privacy Practices

The protection of your health information is important to us at Ophthalmology Associates. We have available to you a comprehensive version of our Notice of Privacy Practices if you wish to read it in its entirety. During the appointment check-in process you will be asked to sign a medical record document acknowledging receipt of the Notice of Privacy Practices. The delivery of your health care services will in no way be conditioned upon your signed acknowledgement. If you have any questions about the Notice of Privacy Practices, please notify an Ophthalmology Associates physician or staff member.

Please Read the Following

I have been provided the opportunity to read the Notice of Privacy Practices at Ophthalmology Associates.

I understand that Ophthalmology Associates is committed to treating and using protected health information about me responsibly. In using this information, this office will comply with all state and federal laws pertaining to your privacy rights, including the Privacy and Security protections provided to you by the Health Insurance Portability and Accountability Act (“HIPAA”).

I understand that my health record is the physical and legal property of Ophthalmology Associates, but the information belongs to me. I may have access to inspect, amend or obtain a copy of my health information. Costs will incur for copies of my records, and appointments must be made with the Privacy Officer to inspect, access, or amend my health information.

I understand that Ophthalmology Associates is required to maintain the privacy of my health information. Ophthalmology Associates will require my authorization to release my health information to outside sources with the exception of disclosures for purposes of Treatment, Payment, and Healthcare Operations. Your authorization will need to be in writing and it will be specific to the disclosure requested. Your authorization for use and disclosure of information, with the exceptions as referenced above, may be revoked in writing at any time. Please notify this office if you ever decide to revoke your consent.

If you believe that your privacy rights have been violated, you may submit a written complaint to our HIPAA Privacy Officer at the address below:

Ophthalmology Associates
1201 Summit Avenue
Fort Worth, TX 76102
Attn: Privacy Officer

Notice Effective Date: April 1, 2003
Notice Revision Date:

ASK US A QUESTION

Fort Worth
Main Office

1201 Summit Avenue
Fort Worth, TX 76102


Telephone:
817-332-2020

Hours 8am to 5pm Monday
thru Friday

Phones answered by
answering service starting at
4:30pm daily

Fort Worth
Cityview

5801 Oakbend Trail,
Suite 100
Ft Worth, TX 76132

Telephone:
817-346-2969

Hours 8am to 5pm Monday
thru Friday

Phones answered by
answering service starting at
4:30pm daily

Hurst Town Center
Medical Plaza

809 W. Harwood Rd.,
Suite 304
Hurst, TX 76054

Telephone:
817-788-9303

Hours 8am to 5pm Monday
thru Friday

Phones answered by
answering service starting at
4:30pm daily

Granbury
Office

3906 Highway 377, Suite 103
Granbury, TX 76049


Telephone:
817-579-0100

Hours 8am to 5pm Monday
thru Friday

Phones answered by
answering service starting at
4:30pm daily

Weatherford
Office

804 Santa Fe Drive
Weatherford, TX 76086


Telephone:
817-594-9500

Hours 8am to 5pm Monday
thru Friday

Phones answered by
answering service starting at
4:30pm daily