
NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION
PLEASE REVIEW IT CAREFULLY
THE PRIVACY OF YOUR HEALTH INFORMATION IS IMPORTANT TO US
USES AND DISCLOSURES OF HEALTH INFORMATION
We use and disclose health information about you for treatment, payment, and healthcare
operations. For example:
Treatment: We may use or disclose your health information to a physician or other healthcare
provider providing treatment to you, or to family and friends you approve.
Payment: We may use and disclose your health information to obtain payment for services we
provide to you.
Healthcare Operations: We may use and disclose your health information in connection with
our healthcare operations. Healthcare operations include quality assessment and improvement
activities, reviewing the competence or qualifications of healthcare professionals, evaluating
practitioner and provider performance, conducting training programs, accreditation, certification,
licensing or credentialing activities.
Your Authorization: In addition to our use of your health information for treatment, payment or
healthcare operations, you may give us written authorization to use your health information or to
disclose it to anyone for any purpose. You also have the right to request restrictions on
disclosure of PHI (Personal Health Information), or alternative means of communication to
ensure privacy.
Marketing Health-Related Services: We will not use your health information for marketing
communications without your written authorization.
Required by Law: We may use or disclose your health information when we are required to do
so by law or national security activities.
Abuse or Neglect: We may disclose your health information to appropriate authorities when
we suspect abuse or neglect.
Appointment Reminders: We may use or disclose your health information to provide you with
appointment reminders (such as voicemail messages, postcards, or letters).
PATIENT RIGHTS
Access: You have the right to look at or get copies of your health information with limited
exceptions. If you request copies, we will charge you a reasonable fee to locate and copy your
information, and postage if you want the copies mailed to you.
Amendment: You have the right to request that we amend your health information.
QUESTIONS AND COMPLAINTS
If you want more information about our privacy practices or have questions or concerns, please
contact us.
If you are concerned that we may have violated your privacy rights, or you disagree with a
decision we made about access to your health information or in response to a request you
made to amend or restrict the use or disclosure of your health information or to have us
communicate with you by alternative means or at alternative locations, you may complain to us
using the contact information listed at the end of this Notice. You also may submit a written
complaint to the U.S. Department of Health and Human Services. We will provide you with the
address to file your complaint with the U.S. Department of Health and Human Services upon
request.
We support your right to the privacy of your health information. We will not retaliate in any way if
you choose to file a complaint with us with the U.S. Department of Health and Human Services.
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