NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION

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.

Your Health Information Rights

The health and billing records we maintain are the physical property of the doctor's office. You have the following rights with respect to your Protected Health Information.

1) Request a restriction on certain uses and disclosures of your health information by delivering the request in writing to our office . we are not required to grant the request but we will comply with any request granted;

2) Obtain a paper copy of the Notice of Privacy Practices for Protected Health Information (.Notice.) by marking a request at our office;

3) Right to inspect and copy your health record and billing record . You may exercise this right by delivering the request in writing to our office using the form we provide to you upon request; appeal a denial of access to your protected health information except in certain circumstances;

4) Right to request that your health record be amended to correct incomplete or incorrect entries by delivering a written request to our office using the form we provide to you upon request. We are not required by law to make such amendments; however, you may file a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached in all future disclosures of your protected health information.

5) Right to receive an accounting of disclosures of your health information as required to be maintained by law by delivering a written request to our office using the form we provide to you upon request. An accounting will not include internal uses of information for treatment, payment, or operations, disclosures made to you or made at your request, or disclosures made to family members or friends in the course or providing care;

6) Right to request the communication of your health information be made by alternative means or at an alternative location by delivering the request in writing to our office.

This office is required to:

Maintain the privacy of your health information as required by law;

Provide you with a notice as to our duties and privacy practices regarding the information we collect and maintain about you;

Abide by the terms of this Notice;

Notify you if we cannot accommodate a requested restriction or request;

Accommodate your reasonable requests regarding methods to communicate health information with you and

Accommodate your request for an accounting of disclosures.
We reserve the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the protected health information we maintain. If our information practices change, we will amend our Notice. You are entitled to receive a revised copy of the Notice by calling and requesting a copy of our .Notice. or by visiting our office and picking up a copy.

Notification- Opportunity to Agree or Object

Unless you object we may use or disclose your protected health information to notify, or assist in notifying, a family member, personal representative, or other person responsible for your care, about your location, and about your general condition, or your death.

Communication with Family - Using our best judgment, we may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person.s involvement in your care or in payment for such care if you do not object or in any emergency.

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

Other Uses and Disclosures

Other uses and disclosures besides those identified in this Notice will be made only as otherwise authorized by law or with your written authorization which you may revoke except to the extent information or action has already been taken.