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Notice of Privacy Practices- Summary

Effective April 2023

IMPORTANT:
THE FOLLOWING IS A BRIEF SUMMARY OF YOUR RIGHTS AND OUR RESPONSIBILITIES AS DETAILED IN THE ATTACHED NOTICE OF PRIVACY PRACTICES (THE “NOTICE”). THIS SUMMARY IS FOR YOUR CONVENIENCE AND IS NOT A SUBSTITUTE FOR READING THE ENTIRE NOTICE AND DOES NOT MODIFY THE TERMS OF THE NOTICE.

  1. Uses and Disclosures of Your Health Information. We keep a record of the health care services we provide you. We may use the information we develop and collect for treatment or disclose the information to others to whom we refer you for treatment, for payment for these services and for certain health care “operations” such as improving the competence and quality of our staff and business planning and management. We may disclose your information to our business associates such as medical transcriptionists, billing services and others who assist in the operations of our organization. We may call you to remind you of appointments and may leave a message on your answering machine if you have one. We may also disclose information to your family about your location and general condition. If you are available and able, we will ask your consent first. We may also use your information to recommend products or services related to your care. Your medical information may be disclosed without your authorization as required by law, for public health purposes, healthcare oversight, including audits and investigations, medical research, judicial and administrative proceedings, subject to the limits imposed by state and federal law, and certain other purposes as specified by law.
  2. Other Uses and Disclosures. Except as described in the Notice, we will not use or disclose your medical information without your written authorization. You can revoke an authorization at any time, except to the extent that we have already taken action in reliance on the authorization.
  3. Your Health Information Rights. You have a number of rights under state and/or federal law which are subject to the terms and conditions specified in the Notice:
    1. You may request restrictions on certain uses and disclosures of your information
    2. You may request that you receive your information from us in a certain way
    3. You may inspect and copy your medical records
    4. You may request an amendment to any record you believe is inaccurate
    5. You may request an accounting of disclosures made of your records
  4. Changes to the Notice. We reserve the right to change the Notice. If we do so, we will post it in our facilities, [and on our website] and provide a copy upon request.
  5. Complaints. You may file a complaint to our Compliance Officer at (360) 776-9853 or with the federal government as detailed in the Notice. You will not be penalized for filing any complaint.

Notice of Privacy Practices, complete document