51950 Van Dyke, Shelby Twp., MI 48316      (586) 254-9030

Privacy Policy

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Privacy Policy Update Date / Time: May 13, 2016 @ 11:09 P.M.

This summary of our privacy practices contains a condensed version of our Notice of Privacy Practices. Our full length notice is available to patients upon their request. 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.


We understand that your medical information is personal to you, and we are committed to protecting that information. As our patient, we create medical records about your health, our care for you, and the services and/or items we provide to you. By law, we are required to make sure that your Protected Health Information (PHI) is kept private.


Here are a few examples of how we use your PHI (for more details, please refer to the full-length Notice of Privacy Practices):

  • For your medical treatment
  • To bill for & obtain payment for our services
  • To run our practice efficiently & ensure that all our patients receive quality care
  • For appointment and patient recall reminders
  • To comply with the law or government requests
  • To help with threats to health or safety
  • For medical examiner or funeral director
  • For organ and tissue donation
  • For workers’ compensation programs
  • For research
  • In response to certain requests arising out of lawsuits or other disputes


You have certain rights regarding the information we maintain about you. These rights include:

  • To inspect & copy your medical records
  • To request changes to your records
  • To request confidential communications
  • Ask to limit the information we share
  • To request a list of whom we share info
  • To a paper copy of this privacy notice

If you believe your privacy rights have been violated, you may file a complaint with Kostesich Optometry or with the U.S. Department of Health & Human Services, Office of Civil Rights. All complaints must be submitted in writing. There is no penalty for filing a complaint. For more information about these rights, please see the detailed Notice of Privacy Practices.

To file a written complaint to Kostesich Optometry of Shelby Twp., MI, send it to:

Dr. Joseph Kostesich, O.D.
51950 Van Dyke Avenue
Shelby Township, Michigan 48317
(586) 254-9030

Privacy Policy Update Date / Time: May 13, 2016 @ 11:09 P.M.
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