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:
You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you.
We will provide a copy or a summary of your health information, usually within 1 day of your request.
You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you.
We will provide a copy or a summary of your health information, usually within 1 day of your request.
You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you.
We will provide a copy or a summary of your health information, usually within 1 day of your request.
You can ask us to correct health information about you that you think is incorrect or incomplete. .
We may say “no” to your request, but we’ll tell you why in writing within 10 days.
You can ask us to contact you in a specific way about your medical information (for example, home or office phone) or to send your medical information to a different address.
We will say, “yes” to all reasonable requests.
You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
We will say, “yes” to all reasonable requests.
Get a list of those with whom we’ve shared information
You can ask for a list (accounting) of the times we’ve shared (disclosed) your health information, for up to six years prior to the date you ask, who we shared it with, and why.
We will include all the disclosures except for those about treatment, payment, and healthcare operations, and certain other disclosures (such as any you asked us to make).
Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, contact us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
Share information with your family, close friends, or others involved in your care
In these following cases, we never share your information unless you give us written permission:
Marketing purposes
Sale of your protected health information
Most sharing of psychotherapy notes
Our Uses and Disclosures
We typically use or share your health information in the following ways:
We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
We can use and share your health information for billing purposes.
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
Help with public health and safety issues
We can share health information about you for certain situations such as:
Preventing disease
Helping with product recalls
Reporting adverse reactions to medications
Reporting suspected abuse, neglect, or domestic violence
Preventing or reducing a serious threat to anyone’s health or safety
We can use or share your information for health research. However, your personal information will be de-identified.
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of
your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, on our website, and we will mail a copy to you.
Effective Date of Notice: 01/23/2024