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Legal

Notice of Privacy Practices

Effective date: May 29, 2026  ·  Version 1.0

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.

1. Our pledge regarding your information

Mims Optique ("we," "our," or "us") is committed to protecting your protected health information ("PHI"). PHI is information that may identify you and that relates to your past, present, or future physical or mental health, the healthcare we provide to you, or payment for that care. We are required by law to maintain the privacy of your PHI, to provide you with this Notice of our legal duties and privacy practices regarding PHI, and to follow the terms of the Notice currently in effect.

2. How we may use and disclose your health information

Treatment

We may use and disclose your PHI to provide eye-care services to you. For example, the doctor performing your exam may share your prescription and findings with our optical staff so that eyewear can be fitted and dispensed. We may also share your information with another healthcare provider involved in your care, such as your primary care physician or an ophthalmologist for referral.

Payment

We may use and disclose PHI so that we can bill and collect payment for your services. For example, we may send claims and supporting information to your vision or medical insurance carrier to verify benefits and obtain reimbursement.

Healthcare operations

We may use and disclose PHI for our day-to-day operations — for example, to evaluate the quality of care, schedule appointments, train staff, and manage our business.

Independent doctors of optometry

Eye exams at Mims Optique are provided by licensed optometrists who operate independently of Mims Optique. These independent doctors may maintain their own medical records and have their own privacy practices. When you receive an exam, your PHI may be shared between Mims Optique and the independent doctor for treatment, payment, and operations purposes as described above.

Appointment reminders and health-related communications

We may contact you by phone, email, or text message to remind you of upcoming appointments, recall you for routine annual care, send post-visit instructions, or provide directions and parking information. If you choose to opt in to text messaging, you may opt out at any time by replying STOP.

As required by law

We will use and disclose your PHI when we are required to do so by federal, state, or local law — for example, in response to a court order, subpoena, public health reporting requirement, or to report suspected abuse, neglect, or domestic violence.

Other limited circumstances

We may also use or disclose PHI to avert a serious threat to health or safety, to assist a coroner or funeral director, for organ or tissue donation, for certain workers' compensation claims, for military or national security purposes, and for inmates of a correctional institution.

3. Uses and disclosures that require your written authorization

Most uses and disclosures of PHI that are not described above will be made only with your written authorization. In particular, the following always require your authorization:

If you authorize a use or disclosure, you may revoke that authorization in writing at any time. Revocation will not affect any uses or disclosures we made in reliance on your prior authorization.

4. Your rights regarding your health information

Right to inspect and copy

You have the right to inspect and obtain a copy of your PHI maintained by Mims Optique. You may request a paper or electronic copy. We may charge a reasonable, cost-based fee.

Right to amend

If you believe your PHI is incorrect or incomplete, you have the right to ask us to amend it. We may deny your request in certain circumstances permitted by law.

Right to an accounting of disclosures

You have the right to request a list of certain disclosures of your PHI made by us in the prior six years, other than disclosures for treatment, payment, healthcare operations, or those made with your authorization.

Right to request restrictions

You have the right to request restrictions on certain uses or disclosures of your PHI. We are not required to agree to a restriction except where you (or someone on your behalf) pay for an item or service in full, out of pocket, and ask that we not disclose information about that item or service to your health plan.

Right to confidential communications

You have the right to ask that we communicate with you about medical matters in a specific way or at a specific location — for example, only at your home address, only by email, or only by phone.

Right to a paper copy of this Notice

You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive it electronically.

Right to be notified of a breach

You have the right to be notified if we (or one of our business associates) discover a breach of your unsecured PHI, as required by federal law.

5. Your prescription is yours

If your doctor issues a prescription for eyeglasses or contact lenses, you will receive a copy at the end of your exam. You may request that we deliver it digitally by email or that we provide a paper copy. You may use your prescription anywhere — with us, at any other optical retailer, or online — in accordance with the FTC Eyeglass Rule and Contact Lens Rule.

6. Changes to this Notice

We reserve the right to change this Notice and to make the new Notice apply to all PHI we maintain, including information created or received before the change. We will post the current Notice in our office and on mimsoptique.com, and we will provide a copy on request.

7. Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer (see contact information below) or with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

8. Contact us

Privacy Officer · Mims Optique
2389 Mountain Ave Suite 3
Scotch Plains, NJ 07076
Phone: (908) 823-6467
Email: privacy@mimsoptique.com

Acknowledgment of Receipt

Please complete and return this section to a member of our staff.

I acknowledge that I have been provided access to Mims Optique's Notice of Privacy Practices and have had the opportunity to review it.

For office use only  ·  Acknowledgment received by: _________________  ·  Date: _________________