Our commitment to your privacy:

Our practice is dedicated to maintaining the privacy of your personal health information as part of providing professional care. We are also required by law to keep your information private. These laws are complicated, but we must give you this important information. This is a shorter version and you will receive a longer one on your first visit.

Disclosing your health information without you consent:

There are specific times when the laws require us to use or share your information.

For example:

  1. When there is a serious threat to you or another’s health and safety or to the public. We will only share information with person who are able to help prevent or reduce the threat.

  2. When we are required to do so by lawsuits and other legal or court proceedings.

  3. If a law enforcement official requires us to do so.

  4. For workers’ compensation and similar benefit programs.

*There are other rare situations. They will be described in the longer version

Your right regarding your health information:

  1. You can ask us to communicate with you in a particular way or at a certain place that is more private for you. For example, you can ask us to call you at home, and not at work, to schedule or cancel an appointment. We will try our best to do as you ask.

  2. You can ask us to limit what we tell people involved in your care or the payment for your care, such as family members and friends.

  3. You have the right to look at the health information we have about you, such as your medical and billing records. You can get a copy of these records, but we may charge you for it. Contact our privacy officer to arrange how to see your records.

  4. If you believe that the information in your records is incorrect or missing something important, you can ask us to make additions to your records to correct the situation. You have to make this request in writing and send it to our privacy officer. You must also tell us the reasons you want to make the changes.

  5. You have the right to a copy of this notice. If we change this notice, we will post the new version in our waiting area, and you can always get a copy of it from the privacy officer.

  6. You have the right to file a complaint if you believe your privacy rights have been violated. You can file a complaint with out privacy officer and with the Secretary of the US Department of Health and Human Services. All complaints must in writing. Filing a complaint will not change the health care provide to you in any way.