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HIPAA Privacy Statement

Patient Rights and Responsibilities

Our office is committed to providing you the highest possible standards of medical/surgical eye care. As a patient you have certain rights and responsibilities.

Patients have a right to expect a certain standard of healthcare, these include:

  • Care that is respectful, which reflects consideration of your personal values and beliefs and which optimizes your comfort and dignity
  • A high standard of professional care from competent and appropriately qualified staff
  • To be informed about facilities, services, costs, medications used, methods of treatment and referrals to other services,
  • Involvement with the healthcare team in the planning and implementation of your care
  • Patients can legally discharge themselves at any time, even against the advice of their doctor or hospital staff. However, they must accept the associated risks and sign a form taking responsibility before declining care
  • Confidentiality of communications and records pertaining to your health care

Patient also have certain responsibilities, these include:

  • To provide accurate and complete information about your condition, past illness and medications as outlined in our health questionnaire
  • To consider other patients in our care; in particular we ask for your cooperation with the control of noise, respect of property and the observation of the non-smoking policy within our facility.
  • To treat all staff members employed by The Aiello Eye Institute with respect and courtesy regardless of their cultural and ethnic background
  • To report whether you clearly understand the planned course of treatment and/or what is expected of you regarding your treatment plan
  • To keep appointments and, when unable to do so for any reason, to notify our office as soon as possible.
  • To promptly fulfill your financial obligation to our office

Dr. Patrick Aiello's personal commitment to his patients:

  • Put respect for the patient's life above all other considerations
  • Provide prompt help to persons whose life or Eyes are endangered by disease or accident
  • Treat all patients without prejudice based on race, religion or gender
  • Administer to patients in material need without thought to recompense
  • Treat the patient with consideration and respect
  • Ensure the privacy of the patient, and maintain confidentiality in all aspects of the patient's treatment
  • Obtain the informed consent of the patient for all interventions.
  • Provide the patient with truthful accurate information about their state of health

Advice on how to make a complaint, compliment or suggestion about your healthcare or treatment

You are entitled to comment on or complain about the services you receive in our facility. If you or your family has any concerns, please direct them to the staff caring for you or the Office Manager.

Dr. Aiello and his staff would also appreciate hearing from you if you have a suggestion for improvement or a compliment about the service.

If you would like to make a statement about the care you received, there are several ways to do this:

  • Contact the office manager directly either in person or by telephone 9287821980
  • Email the office at
  • Write us a letter – Aiello Eye Institute Attn: Office Manager 275 W. 28th St., Yuma AZ 85364

Privacy and your health information

We are values-based organization and are committed to ensuring that we comply with the HIPAA privacy rules as outlined by the U.S. Department of Health and Human Services.

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Notice of Privacy Practice


At the Aiello Eye Institute, we believe that individuals have a right to adequate notice of our policies, procedures and practices with respect to uses and disclosures of protected health information. The Aiello Eye Institute is required by law to maintain the privacy of your health information and to provide you with a notice of our legal duties and privacy practices. We are required to and will abide by the terms in the Notice of Privacy Practices in effect at the time it is provided to you. You have the right to request a paper copy of this Notice of Privacy Practices even if we have already provided a copy to you previously.

The Aiello Eye Institute will not use or disclose your individually identifiable or protected health information other than to carry out health care treatment, payment, and/or operations for you, or as required by law. An example of treatment is a visit to our office for the purpose of diagnosis or care of a health issue wherein doctors, nurses, technicians and/or others will share the information about you in the course of your treatment. Payment includes sharing protected health information with an insurer or a third party that may be responsible for collecting payment from a health plan. Healthcare operations means sharing protected health information for the purpose of quality review.

The Aiello Eye Institute will use and disclose protected health information to business associates in the course of providing treatment, securing payment for such treatment, and/or to facilitate health care operations of our practice, to facilitate the requirements of our business associates' contracts, and to comply with requests from other covered entities to carry out treatment, payment or health care operations.

Except for the purposes described above, The Aiello Eye Institute will only use or disclose protected health information with your express written authorization and you may revoke the authorization at any time in writing. The revocation will apply only to future uses and disclosures.

Any information The Aiello Eye Institute provides to a third party other than to our business associates or other health care providers with a treatment relationship to you will be de-identified or stripped of any and all personal data, which could be used to identify a specific individual.

The Aiello Eye Institute may contact you to provide appointment reminders or to provide you with information about alternative treatments or other health-care services we provide. When receiving communications from us, you may request that we communicate with you at an alternate location or by alternate means and we will make every effort to accommodate your request.

You may request that certain uses and disclosures of your protected health information are restricted. To do so, you must provide the request in writing using the Request for Restriction on Use or Disclosure form available from our office. The Aiello Eye Institute will determine if the information constitutes required information to carry out treatment, payment or health care operations. If, in our sole opinion, your request does not involve information that is required by us to carry out treatment, payment or health care operations, we will accept your request for restrictions and will notify you if your request will be honored within 30 days or as required by law.

With respect to your protected health information, you have the right to request and receive the following from PDA:

Inspection and copying – You may request a report containing your health information that has been collected by The Aiello Eye Institute for you to inspect or obtain a copy. Such requests will be honored within 30 days or as required by law. A nominal fee may be charged for any copying of records.

Amendment or correction – You may request that we amend or correct your health information that has been collected by The Aiello Eye Institute. Upon agreement by your health care provider, requests to amend health information will be honored within 30 days or as required by law, and you will be notified in writing of The Aiello Eye Institute action taken.

Accounting of the disclosures – You may request that we supply you with a listing of the disclosures of your protected health information which have been made by The Aiello Eye Institute except those made for treatment, payment or health care operations, those required by the Final Privacy Rule or made pursuant to other law, and those made pursuant to your explicit authorization.  Such requests will be honored within 30 days or as required by law, and you will be notified in writing of the date on which the accounting will be available to you.  At a minimum, the accounting of disclosures will include the following information:

  • Date of each disclosure.
  • Name and address of the organization of person who received the protected health information.
  • A brief description of the information disclosed.

The Aiello Eye Institute has also required in our business associate contracts that they offer a means to provide such a listing for you.

If you believe that your privacy rights have been violated, you may send questions or complaints about this notice or The Aiello Eye Institute' s privacy practices to us and/or to the Secretary of the Department of Health and Human Services (HHS). Such communication with The Aiello Eye Institute should be directed to: Patrick D. Aiello MD Attn: Office Manager- Office Manager 275 W. 28th St., Yuma AZ 85364. The address of the Secretary of Health and Human Services is 200 Independence Ave. SW, Washington, DC 20201. PDA will not retaliate against you for filing a complaint with the Secretary of HHS.

The Aiello Eye Institute reserves the right to revise this Notice of Privacy Practices at any time without prior notification. You may request a copy of the revised notice and we will provide it to you.

This Notice of Privacy Practices is effective as of January 1st, 2011

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