The Following Describes How Medical Information About You May Be Used And Disclosed And How
You Can Get Access To This Information. Please Review It Carefully.
Our parctice is dedicated to protecting your medical information. We are required
by law to maintain the privacy of protected health information and to provied you with this Notice of our legal duties and
privacy practices with respect to protected health information. Our practice is required by law to abide by the terms of this
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 thst 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.
Our office is required to abide by the terms of this Notice of Privacy Practices.
We may change the terms of our notice, at any time. The new notice will be effective of all protected health infortion
that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices.
To request a revised notice you may call the office and office and request that a revised copy be sent to you in the mail
or asking for one at the time of your next appointment.
How We May Use and Disclose your Medical Information.
We will use your medical information as part of rendering patient care.
For example, your medical information may be use by the doctor or nurse treating you, by the business office to process your
payment for the services rendered and in order to support the business activities of the practice, including, but not
limited to, use by adminsitrative personnel reviewing the quality of the care you receive, employee review activities, training
of medical students, licensing, contacting or arranging for other business activites..
We may also use and/or disclose your information in accordance with federal and state law for
the following purposes:
We may contact you to provide appointment reminders.
We may contact you with inforamtion about treatment alternatives or other health-related benefits
and services that may be of interest to you.
Department of Health
and Human Services.
We may disclose medical information when required by the United States Department of Health
and Human Services as part of an investigation or determination of our complaince with relevant laws.
Family and Friends.
Unless you object, we may disclose your medical information to family members, other relatives
or close personal friends when the medical information is directly relevant to that person's involvement with your care.
Unless you object, we may use or disclose your medical information to notify a family member,
a personal representative or another person responsible for your care of your location, general condition or death.
We may disclose your medical information to a public or private entity, such as the American
Red Cross, for the purpose of coordinating with that entity to assist in disaster relief efforts.
Health Oversight Activities.
We may use or disclose your medical information for public health activvities, including
the reporting of disease, injury, vital events and the condut of public health surveillance, investigation and/or intervention.
We may disclose your medical information to health oversight agency for oversight activities authorized by law, including
audits, investigations, inspections, licensure or disciplinary actions, administrative and/or legal proceedings.
Abuse or Neglect.
We may disclose your medical information when it concerns abuse, neglect or violence
to you in accordance with federal and state law.
We may disclose your medical information in teh course of certain judicial or administrative
We may disclose your medical information for law enforcement purposes or other specialized
and Funeral Directors.
We may disclse you medical information to a coroner, medical examiner or funeral
If you are an organ donor, we may disclose your medical information to an organ
donation and procurement organuzation.
We may use or disclose your medical infromation for certain research purposes if an Institutional
Review Board or a privacy board has altered or waived individual authorization, the review is preparatory to research or the
research is on only decedent's information.