HIPAA Notice of Privacy Practices
Effective date: April 14, 2003
We understand that health information about you and your health is personal.
We are committed to protecting health information about you. We create a record
of the care and services you receive from us. We need this record to provide
you with quality care and to comply with certain legal requirements. This Notice
applies to all of the records of your care generated by this office, whether
made by your personal doctor or others working in this office. This notice will
tell you about the ways in which we may use and disclose health information
about you. We also describe your rights to the health information we keep about
you, and describe certain obligations we have regarding the use and disclosure
of your health information.
We are required by law to:
Make sure that health information
that identifies you is kept private
Give you this Notice of our
legal duties and privacy practices with respect to health information about
you; and
Follow the terms of the Notice
that is currently in effect.
How we may use and disclose health information about you:
For treatment
For payment
For health care operations
For appointment reminders
As required by Law
To avert a serious threat
to health and safety
As required by the Military
or Veterans and Workers Compensation
Public Health risks
Health oversight activities
Lawsuits and disputes
Law enforcement
Coroners, health examiners
and funeral directors
National Security and Intelligence
activities
Protective Services for the
President and others
Security Officials for Inmates
Your rights regarding Health Information about
you:
Right to Inspect and copy
Right to Amend
Right to an Accounting of
Disclosures
Right to Request Restrictions
Right to Request Confidential
Communications
Right to a Paper copy of
this Notice ( full Notice is available upon request )
Changes to this Notice:
We reserve the right to change this Notice. We will post a copy of the current
notice in our facility with the current effective date on the first page.
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