The privacy of your medical information is important to us. In accordance with federal and state laws, we are committed to maintaining the privacy of your protected health information. As part of this commitment, we are providing you with this notice about our privacy practices, legal duties, and your rights concerning your protected health information.
We will follow the privacy practices described in this notice while it is in effect. We reserve the right to change our privacy practices and the terms of this notice at any time, as long as such changes are permitted by applicable law. We will make these changes effective for all protected health information that we maintain, including medical information created or received before we made the changes.
This notice takes effect on April 14, 2003 and will remain in effect until we replace it. You may request a copy of our notice (or any subsequent revised notice) at any time. For more information about our privacy practices, or for additional copies of this notice, please contact us using the information listed at the end of this notice.
We will use and disclose your protected health information for treatment, payment, and healthcare operations. This includes sharing it with third parties, other healthcare providers, and insurers. For example, we may disclose your protected health information to a home health agency that provides care to you, or to a specialist or laboratory at the request of your physician. We may also use your protected health information to obtain payment for your healthcare services, such as by sharing it with your health insurance plan to obtain approval for a hospital stay.
In addition, we may use or disclose your protected health information for business operations, such as quality assessment activities and employee review. These activities may include using a sign-in sheet at the registration desk or calling you by name in the waiting room.
There are other circumstances in which we may use or disclose your protected health information. For example, we may share your information to protect public health or if required by law. We may also share your information if you give us written permission.
You have the right to see and get copies of your medical information, and to ask us to correct any mistakes. You also have the right to request limits on how we use and share your information. To exercise these rights, or for more information about our privacy practices, contact us using the information at the end of this notice.
Name of Contact Person: Dr. Blume
Address: 8366 North Loop 1604 W. Suite 108