Notice of Privacy Practices to Our Patients
This notice is required by the privacy regulations created as a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Our practice is dedicated to maintaining the privacy of your health information. We are required by law to maintain the confidentiality of your health information. We realize that these laws are complicated, but we must provide you with the following important information:
The following circumstances may require us to use or disclose health information:
• To public health authorities and health oversight agencies that are authorized by law to collect information.
• Lawsuits and similar proceedings in response to a court administrative order.
• If required to do so by a law enforcement official
• When necessary to reduce or prevent a serious threat to your health and safety, or the health and safety of another individual or the public. We will only make disclosure to a person or organization able to prevent the threat.
• If you are a member of the US or foreign military forces (including veterans), and if required by the appropriate authorities.
• To federal officials or intelligence and national security activities authorized by law.
• To correctional institutions or law enforcement officials if you are an inmate, or under the custody of a law enforcement official.
• For worker’s compensation and similar programs.
Your Rights Regarding Your Health Information:
• Communications. You can request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home rather than work. We will accommodate reasonable requests.
• You can request a restriction in our use or disclosure under health information for treatment, payment or healthcare operations. Additionally, you have the right to request that we restrict our disclosure of your health information to only certain individuals involved in your care or the payment for your care, such as family members and friends. WE are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you.
• You have the right to inspect and obtain a copy of the health information that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing.
• You may ask us to amend your health information if you believe it is incorrect or incomplete, as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing. You must provide us with a reason that supports your request for amendment.
• Right to a copy of this notice. You are entitled to receive a copy of the Notice of Privacy Practices. You may ask us to give you a copy of this notice at any time.
• Right to file a complaint. If you believe your privacy rights have been violated you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
• Right to provide an authorization for other uses and disclosures. Our practice will obtain our written authorization for uses and disclosures that are not identified by this notice or permitted applicable law.