Notice of Privacy Practices (HIPAA)

PLEASE REVIEW THIS CAREFULLY.

The Health Insurance Portability & Accountability Act of 1996 (HIPAA) is a federal program that requires that all medical and dental records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, are kept properly confidential.

Our Legal Duty

We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your health information. We must follow the privacy practices that are described in this Notice while it is in effect.

Uses and Disclosures of Health Information

We use and disclose health information about you for treatment, payment, and healthcare operations. For example:

• Treatment: We may use or disclose your health information to a physician or other healthcare provider providing treatment to you.
• Payment: We may use and disclose your health information to obtain payment for services we provide to you.
• Healthcare Operations: We may use and disclose your health information in connection with our healthcare operations, which include quality assessment, training programs, and evaluating practitioner performance.

Your Rights regarding Health Information

As a patient, you have the following rights regarding your health information:

• Access: You have the right to look at or get copies of your health information.
• Restriction: You have the right to request that we place additional restrictions on our use or disclosure of your health information.
• Alternative Communication: You have the right to request that we communicate with you about your health information by alternative means or to alternative locations.
• Amendment: You have the right to request that we amend your health information.

Questions and Complaints

If you want more information about our privacy practices or have questions or concerns, please contact us. If you are concerned that we may have violated your privacy rights, you may complain to us using the contact information listed below. You also may submit a written complaint to the U.S. Department of Health and Human Services.