Notice of Privacy Practices

This notice describes how medical information about you may be used, disclosed and how you can get access to the information. Please review it carefully.

This practice is required by law to maintain the privacy and confidentiality of your protected health information and to provide our patients with notice of our legal duties and privacy practices with respect to your protected health information. You have the right to look at or get copies of your health information, with limited exceptions. You must make the request in writing.

We may disclose your health care information to our health care professionals within our practice for the purpose of treatment, payment or health care operations. For each of these categories listed, we have provided a description:

Treatment. We may use and disclose your health information for your treatment. For example, we may disclose your health information to a specialist providing treatment to you.

Payment. We may use and disclose your health information to obtain reimbursement for the treatment and services you receive from us or another entity involved in your care.

Healthcare Operations. We may use and disclose your health information in connection with our healthcare operations.

Individuals Involved in Your Care or Payment for Your Care. We may disclose your health information to your family, friends, or any other individual identified by you when they are involved in your care or in the payment for your care.

Disaster Relief. We may use and disclose your health information to assist in disaster relief efforts.

Required by Law. We may disclose your health information for public health activities, including disclosures to:
• Prevent or control disease, injury or disability;
• Report child abuse or neglect;
• Report reactions to medications or problems with products or devices;
• Notify a person of a recall, repair, or replacement of products or devices;
• Notify a person who may have been exposed to a disease or condition; or
• Notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.

National Security. We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities. We may disclose to correctional institution or law enforcement official having lawful custody the protected health information of an inmate or patient.

Secretary of HHS. We will disclose your health information to the Secretary of the U.S Department of Health and Human Services when required to investigate or determine compliance with HIPPA.

Worker’s Compensation. We may disclose your PHI to the extent authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.

Law Enforcement. We may disclose your PHI for law enforcement purposes as permitted by HIPPA, as required by law, or in response to a subpoena or court order.

Health Oversight Activities. We may disclose your PHI to an oversight agency for activities authorized by law.

Judicial and Administrative Proceedings. We may disclose your health information in the course of any administrative or judicial proceeding.

Research. We may disclose your PHI to researchers when their research has been approved by an institution review board or privacy board.

Coroners, Medical Examiners, and Funeral Directors. We may release your PHI to a coroner or medical examiner.

Fundraising/Marketing. We may contact you to provide you with information about our sponsored activities, including fundraising programs, as permitted by applicable law.