We Respect Your Privacy:
We care about our client’s privacy and strive to protect the confidentiality of your information in this practice. New federal legislation requires that we issue this official notice of our privacy practices. You have the right to the confidentiality of your records and this practice is required by law to maintain the privacy of that information. This practice is also required to abide by the terms of the Notice of Privacy Practices currently in effect. Please review the following information, and if you have any questions regarding this notice, please ask us.
Who abides by the Notice of Privacy Practices:
Any practitioner authorized to enter information into your record, all employees, staff and other personnel at this practice who may need access to your information must abide by this notice. All subsidiary business associates, (i.e., billing services, etc.) at this practice may share information for purposes of billing, training, treatment, payment purposes for health care operations, etc. and must also abide by this notice. Except when treatment is involved, only the minimum of information needed will be shared.
How we may use and disclose information about you :
The following circumstances are categories under which we may use and disclose information without your specific consent or authorization:
- As required during an investigation by law enforcement agencies
- To avert a serious threat to public health and safety
- As required by military command and authorities for medical records
- For worker’s compensation or similar forms for processing claims
- In response to legal proceedings
- To a correctional institution or law enforcement official
- As required by U.S. Food and Drug Administration
- Other covered entities and providers’ payment activities
- Other uses and disclosures required by law
- Uses and disclosures in domestic violence or neglect situations
- Health oversight activities
- Other public health activities
Use and disclosure of your information requiring your written authorization:
Other uses and disclosures of medical information not covered by this notice will be made only with your written authorization. If you give us said authorization, you may revoke this in writing at any time, and thereafter we will cease to use said information for specified purposes. You understand that we cannot revoke authorized disclosures after the fact, and that we must retain accurate records of training and other provisions. You have the right to request in writing restrictions or limitations to exact and specific information we use or disclose about you for training or treatment purposes, but we are not required to agree to specific and written requests. If we do agree, it is with the understanding that we will do so unless information is required under emergency circumstances. You have the right to specify how and where we should send communications to you about your information. To the best of our abilities, we will accommodate all reasonable requests, and reserve the right to deny unreasonable and/or burdensome requests.
Right to inspect, copy and amend your information:
You have the right to inspect and copy information used to make decisions about your care, not including psychotherapy notes, information compiled for a civil, criminal or administrative action or proceeding, and protected health information to which access is prohibited by law. If you request a copy of this information, we reserve the right to charge a fee for the cost of copying, mailing, or other supplies and services involved with your written request. We may deny your request in certain very limited circumstances, and you have the right request that any denial be reviewed. If you feel your information is incorrect or incomplete, you may ask us to amend that information, in writing, and provide us a reason for your request. We may deny such an amendment if the information was not created by us, the information is inaccurate or incomplete, the information is not relevant to the training we provide you in this office, or if it is information that you would not be permitted to inspect and copy. We would prepare, provide you with and keep any rebuttal to your request as part of our record.
Right to accounting of non-standard disclosures:
You have the right to request a list of disclosures we provide about your information. Please submit a request in writing to this practice, and specify the time period of said disclosures that is no longer then six years past, and the form of preferred communication.
If you have any questions about this privacy statement or the practices of this site, please contact us.