Privacy Policy

Our privacy policy is in place to provide assurance that your medical information is secured in a secure password protect electronic medical record. We collect personal information (name/DOB/address/phone number) and health history to provide and maintain our services, and to notify you about changes.

We do not share your information with third parties.. Upon scheduling an appointment you are required to review and sign our HIPPA/privacy policy. You may request your information at any time.

 • You can ask to see or get an electronic or paper copy  of your medical record and other health information  we have about you. Ask us how to do this.  • We will provide a copy or a summary of your health  information, usually within 30 days of your request.  We may charge a reasonable, cost-based fee 

  You can ask us to correct health information about  you that you think is incorrect or incomplete. Ask us  how to do this. 

 • You can ask us to contact you in a specific way (for  example, home or office phone) or to send mail 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. • If you pay for a service or health care item outof-pocket in full, you can ask us not to share that  information for the purpose of payment or our  operations with your health insurer. • We will say “yes” unless a law requires us to share  that information 

 • You can complain if you feel we have violated your  rights by contacting us using the information on the  back page. • You can file a complaint with the U.S. Department  of Health and Human Services Office for Civil Rights  by sending a letter to 200 Independence Avenue,  S.W., Washington, D.C. 20201, calling 1-877-696- 6775, or visiting www.hhs.gov/ocr/privacy/hipaa/ complaints/. • We will not retaliate against you for filing a complaint. Notice of Privacy Practices • Page  

 For certain health information, you can tell us your choices about what  we share. 

 • Share information with your family, close friends, or  others involved in your care • Share information in a disaster relief situation • Include your information in a hospital director 

 How do we typically use or share your health information? We typically use or share your health information in the following ways. Treat you • 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. Run our  organization • 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.  Bill for your  services • We can use and share  your health information  to bill and get payment  from health plans or  other entities.  Example: We give  information about  you to your health  insurance plan so it will  pay for your services 

 How else can we use or share your health information? 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. For more information see:  www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html 

 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 Do research • We can use or share your information for health  research.  Comply with  the law • 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. 

 Work with a  medical examiner  or funeral director • We can share health information with a coroner,  medical examiner, or funeral director when an  individual dies. Address workers’  compensation,  law enforcement,  and other  government  requests • We can use or share health information  about you: • For workers’ compensation claims • For law enforcement purposes or with a law  enforcement official • With health oversight agencies for activities  authorized by law • For special government functions such as  military, national security, and presidential  protective services Respond to  lawsuits and  legal actions • 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.  For more information see: www.hhs.gov/ocr/privacy/hipaa/ understanding/consumers/noticepp.html. Changes to the Terms of This Notice 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, in our office, and on our web site