HIPAA / FERPA
NOTICE OF PRIVACY PRACTICES
Understanding Your Health Record/Information
Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, diagnosis, treatment, and a plan for future care or treatment. We use this information, often referred to as your medical record, as a basis for planning your care and treatment, a means to obtain payment for treatment, for administrative purposes, and to evaluate the quality of care that you receive. In any other situation, we will ask for your written authorization before using or disclosing any identifiable health information about you. If you choose to sign an authorization to disclose information, you can later revoke that authorization to stop any future uses and disclosures. Understanding what is in your record and how your health information is used helps you to ensure its accuracy, better understand who, what, when, where, and why others may access your health information, and make more informed decisions when authorizing disclosure to others. We also send appointment reminders and call your home to leave appointment reminders with spouses, family members or on answering machines.
We may change our policies at any time. Before we make a significant change in our policies, we will change our notice and post the new notice in the waiting area. You can also request a copy of our notice at any time. For more information about our privacy practices, contact our Operations Director, Julie Helm at firstname.lastname@example.org
In most cases, you have the right to look at or get a copy of health information about you that we use to make decisions about you. If you request copies, we will charge you 10 cents for each page. You also have the right to receive a list of instances where we have disclosed health information about you for reasons other than treatment, payment or related administrative purposes. If you believe that information in your record is incorrect or if important information is missing, you have the right to request that we correct the existing information or add the missing information.
You may request in writing that we not use or disclose your information for treatment, payment and administrative purposes. We are legally required to honor your request.
If you are concerned that we have violated your privacy right, or you disagree with a decision we made about access to your records, you may contact our Operations Director, Julie Helm at email@example.com. You may also send a written complaint to our clinic.
Our Legal Duty
We are required by law to protect the privacy of your information, provide this notice about our information practices, and follow the information practices that are described in this notice and in our policy.
You may request a written copy of this policy. Contact our office by emailing firstname.lastname@example.org.