Updated August 6, 2022
II. INFORMATION COLLECTED
- Personal identifying information such as name, postal address, e-mail address, telephone number, or any other identifier by which you may be contacted online or offline (“Personal Information”);
- Information about your internet connection, the equipment you use to access our Website, and usage details;
- Information that you provide by filling in forms on our Website. This includes information provided at the time of making an appointment or requesting further services. We may also ask you for information when you enter a contest or promotion sponsored by us, and when you report a problem with our Website;
- Records and copies of your correspondence (including email addresses), if you contact us;
- Information relating to your search queries on the Website; and
- Protected Health Information (“PHI”) as defined and regulated by the U.S. Department of Health and Human Services.
III. RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
- Get an electronic or paper copy of your medical record
- You can ask to see or get an electronic or paper copy of your medical record and other PHI we have about you. Ask us how to do this.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
- Ask us to correct your medical record
- You can ask us to correct PHI about you that you think is incorrect or incomplete. Ask us how to do this.
- We may say “no” to your request, but we’ll tell you why in writing within 60 days.
- Request confidential communications
- You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
- We will say “yes” to all reasonable requests.
- Ask us to limit what we use or share
- You can ask us not to use or share certain PHI for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
- Get a list of those with whom we’ve shared information
- You can ask for a list (accounting) of the times we’ve shared your PHI for six years prior to the date you ask, who we shared it with, and why.
- We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
- Get a copy of this privacy notice
- You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
- Choose someone to act for you
- If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will make sure the person has this authority and can act for you before we take any action.
- File a complaint if you feel your rights are violated
- You can complain if you feel we have violated your rights by contacting us using the contact information below.
- You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/ocr/privacy/hipaa/complaints/.
- We will not retaliate against you for filing a complaint.
V. USE AND DISCLOSURE OF YOUR INFORMATION A. USE OF INFORMATION EXCLUDING PROTECTED HEALTH INFORMATION
- To present our Website and its contents to you.
- To provide you with information, products, or services that you request from us.
- To fulfill any other purpose for which you provide it.
- To carry out our obligations and enforce our rights arising from any contracts entered into between you and us, including for billing and collection.
- To notify you about changes to our Website or any products or services we offer or provide though it.
- To contact you about our own and third-parties’ goods and services that may be of interest to you.
- To enable us to display advertisements to our advertisers’ target audiences. Even though we do not disclose your personal information for these purposes without your consent, if you click on or otherwise interact with an advertisement, the advertiser may assume that you meet its target criteria.
- In any other way we may describe when you provide the information.
- For any other purpose with your consent.
B. DISCLOSURE OF INFORMATION EXCLUDING PROTECTED HEALTH INFORMATION
- To our subsidiaries and affiliates.
- To contractors, service providers, and other third parties we use to support our business.
- To a buyer or other successor in the event of a merger, divestiture, restructuring, reorganization, dissolution, or other sale or transfer of some or all of our assets, whether as a going concern or as part of bankruptcy, liquidation, or similar proceeding, in which personal information about our Website users is among the assets transferred.
- To third parties to market their products or services to you if you have not opted out of these disclosures.
- To fulfill the purpose for which you provide it.
- For any other purpose disclosed by us when you provide the information.
- To comply with any court order, law, or legal process, including responding to any government or regulatory request.
- If we believe disclosure is necessary or appropriate to protect the rights, property, or safety of the Company, our customers, or others.
C. USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION
- To treat you: We can use your PHI and share it with other professionals who are treating you.
- To run our organization: We can use and share your PHI to run our practice, improve your care, and contact you when necessary.
- To bill for services: We can use and share your PHI to bill and get payment from health plans or other entities.
- To help with public health and safety issues; we can share PHI about you for certain situations such as:
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone’s health or safety.
- We can use or share your information for health research.
- To comply with the law: We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
- To respond to organ and tissue donation requests: We can share PHI about you with organ procurement organizations.
- To work with a medical examiner or funeral director: We can share PHI with a coroner, medical examiner, or funeral director when an individual dies.
- To address workers’ compensation, law enforcement, and other government requests
- For workers’ compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services.
- To respond to lawsuits and legal actions: We can share PHI about you in response to a court or administrative order, or in response to a subpoena.
VI. YOUR CHOICES ABOUT YOUR INFORMATION
- Disclosure of Your Information for Third-Party Advertising. If you do not want us to share your personal information with unaffiliated or non-agent third parties for promotional purposes, you can opt-out by sending us an email stating your request to firstname.lastname@example.org.
- Promotional Offers from the Company. If you do not wish to have your contact information used by the Company to promote our own or third parties’ products or services, you can opt-out by sending us an email stating your request to email@example.com. If we have sent you a promotional email, you may send us a return email asking to be omitted from future email distributions.
- Protected Health Information. We will not sell your PHI or use your PHI for marketing purposes unless you give us written permission. You also have the right and choice to tell us to:
- Share PHI with your family, close friends, or others involved in your care
- Share PHI in a disaster relief situation
- Include your information in a hospital directory.
VII. DATA SECURITY
IX. GOVERNING LAW
X. QUESTIONS & FEEDBACK