Dr. Stuart Glass

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Glass Vision Associates, P.A. Notice of Privacy Practices Effective date of notice: April 14, 2003 GLASS VISION ASSOCIATES, P.A. Dr. Stuart Glass, Dr. Marcia Glass 1001 Southwest 2nd Avenue, # 4000 Boca Raton, FL 33432 (561) 391-2362 This notice describes how medical information about you may be used and disclosed, and how you can obtain access to this information. Please review it carefully. General Rule We respect our legal obligation to keep health information, which identifies you, private. The law obligates us to give you notice of our privacy practices. Generally, we can only use your health information in our office or disclose it outside of our office, without your written permission, for purposes of treatment, payment or healthcare operations. In most other situations, we will not use or disclose your health information unless you sign a written authorization form. In some limited situations, the law allows or requires us to disclose your health information without written authorization. Uses or Disclosures of Health Information Examples of how we use information for treatment purposes:

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