NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THE INFORMATION
PLEASE REVIEW IT CAREFULLY
THE PRIVACY OF YOUR HEALTH INFORMATION IS IMPORTANT TO US
USES AND DISCLOSURES OF HEALTH INFORMATION
We may use and disclose health information about you for treatment, payment, and healthcare operations. For example:
Treatment: We may use and disclose your health information to a physician, healthcare provider, family and friends you approve
Payment: We may use and disclose your health information to obtain payment for services we provide you.
Healthcare Operations: We may use and disclose your health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, review the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities.
Your Authorizations: In addition to our use of your health information for treatment, payment or healthcare operations, you may give us written authorization to use your health information or to disclose it to anyone for any purpose. You may also give us the right to request restrictions on disclosure of PHI (personal health information), or alternative means of communication to ensure privacy.
Marketing Health-Related Services: We will not use your health information for marketing communications without your written consent.
Required by Law: We may use or disclose your health information when we are required to do so by law or national security activities.
Abuse or Neglect: We may disclose your health information to appropriate authorities when we suspect abuse or neglect.
Appointment Reminders: We may use or disclose your information to provide you with appointment reminders (such as voicemail messages, on line email reminders, postcards, or letters).
Access: You have the right to view or get copies of your health information with limited exceptions. If you request copies, we will charge you __________ to locate and copy your information, and postage if necessary.
Amendment: You have the right to request we amend your health information.
QUESTIONS AND COMPLAINTS
If you want more information about our privacy practices, or have questions or concerns, please feel free to contact us.
We support the right to the privacy of your health information. We will not retaliate in nay way if you choose to file a complaint against us with the U.S. Department of Health and Human Services.