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Effective
Date: April 14, 2003
THIS
NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE
REVIEW IT CAREFULLY.
We understand that
your medical information is personal to you, and we are committed to
protecting the information about you. As our patient, we create
medical records about your health, our care for you, and the services
and/or items we provide to you as our patient. By law, we are required to make
sure that your protected health information is kept private.
How will we use or
disclose your information?
Here are a few examples (for more detail please refer to the
Notice of Privacy Practices):
·
For medical
treatment
·
For
research
·
To
obtain payment for our services
·
To avert
a serious threat to health or safety
·
In
emergency situations
·
For
organ and tissue donation
·
For
appointment and patient recall reminders
·
For
workers’ compensation programs
·
To run
our Practice more efficiently and ensure all our patients receive
quality care
·
In
response to certain requests arising out of lawsuits or other disputes
If you believe your
privacy rights have been violated, you may file a complaint with the
Practice or with the Secretary of the Department of Health and Human
Services. To file a
complaint with the Practice, contact our administrator. All complaints must be submitted
in writing. You will not be
penalized for filing a complaint.
You have certain
rights regarding the information we maintain about you. These rights include:
·
The
right to inspect and copy
·
The
right to request restrictions
·
The
right to amend
·
The
right to a paper copy of this notice
·
The
right to an accounting of disclosures
·
The
right to request confidential communications
For more information
about these rights, please see the detailed Notice of Privacy Practices
that is available through our Privacy Officer, Margaret Thuku, Director
of Quality Assurance.
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