HIPAA Privacy Statement

Patient Privacy Notice

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. The privacy of your medical information is important to us.

Our Legal Duty

We are required by applicable federal and state laws to maintain the privacy of your protected health information. We are also required to provide this notice about our privacy practices, legal duties, and your rights concerning your protected health information. We must follow the practices described in this notice while it is in effect.

Effective Date: April 4, 2025 — until replaced.

You may request a copy of this notice (or any revised notice) at any time. For more information, please contact us using the information at the end of this notice.

Uses and Disclosures of Protected Health Information

We may use and disclose your protected health information for the purposes of treatment, payment, and health care operations. Below are examples of each:

Treatment

We may use and disclose your health information to provide, coordinate, or manage your care.
Example: We may share your information with a home health agency or a referred physician to ensure continuity of care.

Payment

We may use your information to obtain payment for health care services.
Example: We may share information with your insurance company to get approval for a hospital stay.

Health Care Operations

We may use or disclose your information for administrative and quality improvement activities.

Examples:

• Using a sign-in sheet or calling your name in the waiting room

• Contacting you for appointment reminders

• Training students or conducting audits

• Working with third-party "business associates" (e.g., billing services)
  
  

You may opt out of receiving certain promotional materials by contacting us.

Uses and Disclosures Requiring Authorization

We will not use or disclose your health information for purposes not listed above unless you give us written authorization. You may revoke your authorization in writing at any time.

Others Involved in Your Care

Unless you object, we may disclose information to family or others involved in your care. If you are unable to agree or object, we may share information based on professional judgment if it is in your best interest.

Additional Uses and Disclosures

Marketing

We may contact you with treatment alternatives or health-related benefits. You may opt out at any time.

Research, Death, Organ Donation

We may use or disclose your information for approved research, to coroners, funeral directors, or organ donation organizations.

Public Health and Safety

We may disclose your information to:

• Prevent or lessen serious health threats

• Government agencies for oversight

• Public health authorities
  
  

Health Oversight

We may disclose information to oversight agencies for audits, inspections, or investigations.

Abuse or Neglect

We may report suspected abuse, neglect, or domestic violence as required by law.

FDA Disclosures

We may disclose information to comply with FDA requirements (e.g., product recalls, tracking, safety).

Criminal Activity

We may disclose information to prevent a serious threat or to assist law enforcement.

Required by Law

We will disclose your information when legally required, such as by the Department of Health and Human Services or for workers' compensation.

Legal Proceedings

We may disclose your information in response to a court order, subpoena, or other legal processes.

Law Enforcement

We may disclose limited information for law enforcement purposes, such as locating a suspect or reporting a crime.

Your Rights

Access

You have the right to view or receive copies of your health information.
Requests must be made in writing. Fees: $25 per page or $10/hour for labor. Postage may apply.

Accounting of Disclosures

You may request a list of disclosures made after April 14, 2016, excluding those for treatment, payment, or operations.
One request per year is free; additional requests may incur a reasonable fee.

Restrictions

You may request limits on our use/disclosure of your information. While we are not required to agree, we will honor agreed-upon restrictions in writing.

Confidential Communication

You may request that we communicate with you through alternative methods or locations. Requests must be in writing.

Amendment

You may request corrections to your information. Requests must be in writing and include reasons. If denied, you may submit a statement of disagreement.

Electronic Notice

If you receive this notice electronically, you may request a paper copy by contacting us.