NOTICE OF PRIVACY PRACTICES (NPP)

Effective Date: 04/04/2026

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.

Aykanush Sungulyan A PC, a California professional corporation doing business as RevitalEyes Optometry ("we," "us," "our"), is committed to maintaining the privacy of your protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the California Confidentiality of Medical Information Act (CMIA) (Cal. Health & Safety Code §56 et seq.), as well as other applicable federal and state health privacy laws. We are legally required to maintain the confidentiality of your health information, to provide you with this Notice of our privacy practices, and to abide by the terms of this Notice currently in effect.

This Notice applies to Protected Health Information (PHI) — information related to your health, the care we provide, or payment for that care, that identifies you as a patient. It does not govern information collected through our website or other non-clinical channels. For information about how we handle non-PHI personal information collected through our website, and your rights under California privacy law (CCPA/CPRA), please refer to our separate Privacy Policy. For information about your use of our website generally, please refer to our Terms and Conditions.

1. USES AND DISCLOSURES FOR TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS

We may use or disclose your health information for purposes of treatment, payment, and health care operations without requiring your written authorization. These uses and disclosures include, but are not limited to:

Treatment

  • Scheduling or rescheduling appointments by phone, voicemail, email, or text message
  • Calling your name in the reception area
  • Discussing diagnoses and treatment options with you and your referring providers
  • Prescribing glasses, contact lenses, medications, and providing necessary prescription information to third parties
  • Referring you to another healthcare provider or obtaining records from past providers
  • Discussing your care in the presence of individuals you allow into treatment rooms

Communication Preferences and Security: You may request confidential communications (for example, a preferred phone number or mailing address). Please do not send detailed medical information through standard email, SMS, or general website inquiry forms. For clinical communications, please use our secure patient intake tools, patient portal if offered, or contact our office directly at (818) 797-5858 for appropriate secure options. When we use phone, email, or text messaging for administrative purposes such as scheduling, we limit content to what is reasonably necessary.

Payment

  • Verifying insurance eligibility and benefits
  • Submitting claims to your health insurer or other payor
  • Sending billing statements and payment reminders to the designated responsible party
  • Collecting outstanding balances, including through external collection agencies or legal means
  • Responding to insurance audits or inquiries
  • Restricting disclosures if you have paid for services out of pocket and requested such restriction

Health Care Operations

  • Quality assessment and improvement activities
  • Business planning and administrative tasks
  • Licensing, credentialing, and insurance audits
  • Legal services and risk management
  • Conducting or arranging for medical reviews, audits, or compliance programs
  • Compliance with requests from state and federal regulatory authorities

2. OTHER USES AND DISCLOSURES PERMITTED OR REQUIRED BY LAW

In certain circumstances, we may use or disclose your PHI without your written authorization as permitted or required by law, including:

  • When required by federal, state, or local law
  • For public health activities (e.g., reporting communicable diseases)
  • To report suspected abuse, neglect, or domestic violence
  • For health oversight activities (e.g., audits, inspections, licensing)
  • In judicial or administrative proceedings, in response to a court order, subpoena, or discovery request
  • To medical examiners, coroners, or funeral directors for identification or cause-of-death purposes
  • To organ and tissue donation organizations
  • To prevent or reduce a serious threat to health or safety
  • For specialized government functions such as military, national security, or intelligence activities
  • In relation to workers' compensation claims
  • As part of de-identified information where permitted by law
  • As incidental disclosures that cannot be reasonably prevented

3. DISCLOSURES TO FAMILY MEMBERS AND PATIENT REPRESENTATIVES

Unless you object, we may disclose relevant portions of your health information to family members, friends, or caregivers involved in your treatment or payment. If you allow someone to accompany you in the treatment area or provide them access to your information, we will infer consent for their involvement. Our staff may also take reasonable calls or instructions from someone acting on your behalf regarding appointments, order pickups, or account questions, within privacy limits.

4. BUSINESS ASSOCIATES

We may disclose your health information to third-party vendors and contractors (known as "Business Associates") that perform services on our behalf (e.g., electronic medical records, billing services, cloud platforms, and patient intake tools). Business Associates are required by law and contract to maintain the confidentiality and security of your information. They, in turn, must ensure the same with any subcontractors.

5. MARKETING, RESEARCH, AND OTHER USES REQUIRING AUTHORIZATION

We will not use or disclose your information for:

  • Marketing communications
  • Sale of your health information
  • Research purposes (note: HIPAA permits limited research-related uses or disclosures without individual authorization in narrow circumstances, such as with a waiver from an Institutional Review Board or Privacy Board, or for certain preparatory-to-research activities; we do not currently engage in such activities, but we will comply with applicable HIPAA requirements if we do so in the future)

...without your explicit written authorization, except as otherwise permitted by law. You may revoke such authorizations at any time in writing to our Privacy Officer. Revocation will not apply to disclosures already made in reliance on the authorization.

6. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the following rights under federal and California law:

  • Right to Access: You may request to inspect or obtain copies of your health records in paper or approved electronic format (for example, secure email or an authorized patient portal). Under California law, we generally must permit inspection of records during business hours within five (5) working days of a proper request, and must generally transmit copies within fifteen (15) days after receiving a proper request, subject to applicable exceptions. HIPAA generally requires us to act on requests for access within thirty (30) calendar days, with a limited extension permitted in some circumstances. Where California law provides greater access rights or a shorter timeframe, we will follow California law.
  • Right to Amend: You may request corrections if you believe the information in your record is inaccurate or incomplete.
  • Right to an Accounting of Disclosures: You may request a list of non-routine disclosures (not related to treatment, payment, or operations) made over the past six (6) years.
  • Right to Restrict Disclosures: You may request limits on how we use or disclose your information. We are not required to agree to all restriction requests, but we will honor agreed-upon restrictions. Please note: under HIPAA, we are required to honor a restriction request if you have paid out of pocket in full for the service and ask us not to disclose information about that service to your health plan.
  • Right to Confidential Communications: You may request that we contact you in a specific manner (e.g., at a different address or phone number).
  • Right to a Copy of This Notice: You may request a paper or digital copy of this Notice at any time.

All rights requests must be made in writing to the Privacy Officer at the contact listed below. We will respond within the timeframes required by applicable law. The rights described in this section apply to your PHI as a patient. For rights regarding non-PHI personal information collected through our website, please refer to our Privacy Policy.

7. DATA BREACH NOTIFICATION

If a breach of your unsecured PHI occurs, we will notify you as required by HIPAA and the California Confidentiality of Medical Information Act (CMIA) (Cal. Health & Safety Code §56.06). HIPAA generally requires written notification within sixty (60) days of discovery. California law requires notification in the most expedient time possible and without unreasonable delay. Where California law imposes a stricter or earlier requirement, we will comply with the California standard. In the event of a breach affecting five hundred (500) or more California residents, we will also notify the California Attorney General as required by applicable law.

8. DATA RETENTION

We retain patient records for at least the minimum period required by applicable law and professional standards. For optometry records in California, this generally means at least seven (7) years from completion of treatment, and for minors, at least seven (7) years and at least until the patient reaches nineteen (19) years of age, subject to any longer period required by law, payer obligations, or specific clinical circumstances. This section applies to PHI and patient health records only. For retention of non-PHI personal information collected through our website, please refer to our Privacy Policy.

9. WEBSITE AND ONLINE COMMUNICATIONS

This Notice governs Protected Health Information (PHI) related to your care as a patient. It does not govern information collected through our website or other non-clinical online channels. For details about cookies, tracking technologies, analytics tools, and other information collected through our website — as well as your rights under California privacy law (CCPA/CPRA) — please refer to our Privacy Policy. Please do not send detailed medical information through standard email, SMS, or general website inquiry forms. For clinical communications, please use our secure patient intake tools, patient portal if offered, or contact our office directly at (818) 797-5858 for appropriate secure options.

10. MINOR PATIENTS

We provide optometric care to minor patients. Health information for minor patients is handled in accordance with HIPAA, CMIA, and applicable California law. In general, a parent or legal guardian is authorized to access and request records for a minor patient. However, California law recognizes limited circumstances in which a minor may consent to their own care and, in those circumstances, the minor — rather than the parent or guardian — may control access to records related to that care. If you have questions about record access for a minor patient, please contact our Privacy Officer using the information in Section 13.

11. CHANGES TO THIS NOTICE

We reserve the right to revise this Notice at any time. Changes will apply to all current and future records and will be posted in our office and on our website. The effective date at the top of this Notice reflects the date the current version took effect. You may request a current copy from our staff at any time.

12. COMPLAINTS

If you believe your privacy rights regarding your PHI have been violated, you may file a complaint with our Privacy Officer at the contact information in Section 13, or with the U.S. Department of Health & Human Services, Office for Civil Rights:

U.S. Department of Health & Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Toll Free: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints

You will not be retaliated against for filing a complaint. For complaints related to non-PHI personal information collected through our website, please refer to our Privacy Policy and Terms and Conditions.

13. CONTACT INFORMATION

For privacy concerns, record access requests, accommodations, or to file a complaint:

Aykanush Sungulyan A PC (DBA RevitalEyes Optometry)
Attn: Privacy Officer
4842 Van Nuys Boulevard, Sherman Oaks, CA 91403

Email: legal@revitaleyesoptometry.com
Subject: NPP Request

Phone: 1-818-797-5858
TTY/TDD: 711 (Relay Service for people with hearing or speech disabilities)