NOTICE OF PRIVACY PRACTICES

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.


Your Rights
You have the right to:

  • Get a copy of your paper or electronic medical record
  • Request corrections to your medical record if you believe it is incorrect or incomplete
  • Request confidential communications (e.g., we can contact you at a different address or phone number)
  • Ask us to limit what we use or share (though we are not always required to agree)
  • Receive a list (accounting) of disclosures we’ve made of your health information
  • Get a copy of this Notice at any time
  • Choose someone to act for you (such as a medical power of attorney or legal guardian)
  • File a complaint if you believe your privacy rights have been violated


Your Choices
You can tell us your choices about how we share your information. For example, you can:


  • Share information with family members involved in your care
  • Share information for disaster relief situations
  • Restrict sharing for marketing purposes


If you cannot tell us your preferences (for example, if you are unconscious), we may share your information if we believe it is in your best interest or if required by law.


Our Uses and Disclosures

We may use and share your health information in the following ways:


  • Treatment – To provide, coordinate, or manage your care (e.g., sharing information with your pediatrician or specialists).
  • Payment – To bill and receive payment from insurance plans or other payers.
  • Health Care Operations – For internal operations, such as quality assessment, staff training, and licensing.


We are also allowed or required to share your information in other ways, usually to contribute to public good, such as:


  • Preventing disease
  • Reporting suspected abuse or neglect
  • Complying with law enforcement or court orders
  • Responding to government health oversight requests
  • Addressing workers’ compensation, law enforcement, or other government requests


We will never sell your information or share it for marketing purposes without your written authorization.


Our Responsibilities
We are required by law to:

  • Maintain the privacy and security of your protected health information (PHI).
  • Notify you promptly if a breach occurs that may have compromised your information.
  • Follow the duties and privacy practices described in this Notice.
  • Not use or share your information other than as described here unless you authorize us in writing.


Complaints

If you believe your privacy rights have been violated, you may file a complaint:


With Us:


With the U.S. Department of Health & Human Services:


You will not be penalized for filing a complaint.


Changes to This Notice

We may update this Notice at any time. The new Notice will apply to all medical information we maintain. Updated Notices will be available in our office and on our website.