Privacy Policy

Privacy Policy

Disclosure of your Protected Healthcare Information, (PHI), how it may be used and disclosed and how you can get access to this information.

This practice is required under the Health Insurance Portability and Accountability Act of 1966 (HIPPA) (a federal program that requires all medical and dental records and other individually identifiable health information used or disclosed by us in any form, whether verbally, electronically or on paper) to maintain the privacy and confidentiality.  With respect to your Protected Health Information (PHI) records, this Act gives you rights to understand and control how your PHI is used.  HIPPA provides penalties for covered entities that misuse PHI. This Notice of Privacy Practices describes how we may use and disclose your PHI.

We may use or disclose, as needed, your PHI to other healthcare professionals within our practice for the purpose of treatment, payment or healthcare operations in order to support the business activities of your physician’s practice. The following include but are not limited examples of these activities:

"On occasion, it may be necessary to seek consultation regarding your condition from other health care providers associated with this practice."

"It is our policy to provide a substitute health care provider, authorized by this practice to provide assessment and/or treatment to our patients, without advanced notice, in the event of your primary health care provider's absence due to vacation, sickness, or other emergency situation."

“We may use a sign-in sheet at the registration desk, we may contact you to remind you of your appointment and leave a message, e-mail or we may mail correspondence to your home address.  If you prefer that we call or contact you at another telephone or location, please let us know.

We may disclose your Protected Health Information (PHI) without your authorization.  These situations include:

Payment – for the purpose of obtaining authorization, payment or health care operations.

Workers' Compensation –  as necessary to comply with State Workers' Compensation Laws.

Emergencies –  as necessary to notify or assist in notifying a family member, or another person responsible for your care about your medical condition or in the event of an emergency or of your death.

Public Health – as required by law, to public health authorities for purposes related to: preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.

Judicial and Administrative Proceedings – in the course of any administrative or judicial proceeding.

Law Enforcement – to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena, and other law enforcement purposes.

Deceased Persons – to coroners or medical examiners.

Organ Donation – to organizations involved in procuring, banking, or transplanting organs and tissues.

Research – to researchers conducting research that has been approved by an Institutional Review Board.

Public Safety – in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or to the general public.

Specialized Government Agencies – for military, national security, prisoner and government benefits purposes.

Change of Ownership
In the event that this practice is sold or merged with another organization, your Protected Health Information (PHI)/record will become the property of the new owner.

Your Health Information Rights:

  • You have the right to request restrictions on certain uses and disclosures of your PHI. Please be advised, however, that this practice is not required to agree to the restriction that you requested.
  • You have the right to have your PHI received or communicated through an alternative method or sent to an alternative location other than the usual method of communication or delivery, upon your request.
  • You have the right to inspect and copy your PHI.
  • You have a right to request that this practice amend your PHI. Please be advised, however, that this practice is not required to agree to amend your PHI. If your request to amend your PHI has been denied, you will be provided with an explanation of our denial reason(s)and information about how you can disagree with the denial.
  • You have a right to receive an accounting of disclosures of your PHI made by this practice.
  • You have a right to a paper copy of this Notice of Privacy Practices at any time upon request.

Changes to this Notice of Privacy Practices
This practice reserves the right to amend this Notice of Privacy Practices at any time in the future, and will make the new provisions effective for all information that it maintains. Until such amendment is made, this practice is required by law to comply with this notice.

If you have questions about any part of this notice or if you want more information about your privacy rights please contact this office.

Complaints about your Privacy rights or how this practice has handled your health information should be directed by calling this office.  If you are not satisfied with the manner in which this office handles your complaint, you may submit a formal complaint to the Secretary of health and Human Services.


E-mail:[email protected]


We work for your health and well-being.