Notice of Privacy Practices Summary

This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. Protected health information is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.

1.       Uses and Disclosures of Protected Health Information

Your protected health information may be used and disclosed by your physician, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you. Your protected health information may also be used and disclosed to payment of your health care bills and to support the operation of the physician’s practice.

A.       Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below.

B.       Other permitted and required uses and disclosures that may be made with your consent, authorization or opportunity to object

 1. Others involved in your healthcare

 2.  Emergencies

 3.  Communication barriers

C.  Other permitted and required uses and disclosures that may be made without your consent, authorization or opportunity to object

         1.   Required by law

         2.   Public health

         3.   Communicable diseases

         4.   Health oversight

         5.   Abuse or neglect

         6.   Food and Drug Administration

         7.   Legal proceedings

         8.   Law enforcement

         9.   Coroners, funeral directors, and organ donation

        10.  Research

        11.  Criminal activity

        12.  Military activity and national security

        13.  Workers’ compensation

        14.  Inmates

        15.  Required uses and disclosures

2.       Your Rights

A.       You have the right to inspect and copy your protected health information.

B.       You have the right to request a restriction of your protected health information.

C.      You have the right to receive confidential communications from us by alternative means or at an alternative location.

D.      You may have the right to have your physician amend your protected health information.

E.       You have the right to obtain a paper copy of this notice from us.

3.       Complaints

You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us.

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