Notice of Privacy Practices

Without Your Consent: Without your consent, we may use or disclose your personal health information in order to provide you with services and the treatment you require or request, to collect payment for those services, and to conduct other related health care operations otherwise permitted or required by law. Even so, we are required to limit such uses or disclosures to the minimal amount reasonably required.

Examples of treatment activities include: (a) the provision, coordination, or management of health care and related services by health care providers, including sending prescriptions to your pharmacy; (b) consultation between health care providers relating to a patient; or (c) referral of a patient for health care from one provider to another.

Examples of payment activities include: (a) billing and collection activities; (b) medical necessity and appropriateness of care reviews.

Examples of health care operations include: (a) development of clinical guidelines; (b) contacting patients with information about treatment alternatives; (c) reviewing qualifications of and training health care professionals; (d) quality assessment and general administrative activities.

As Required By Law: We may use or disclose your personal health information to the extent required by law, including: public health activities; disclosures regarding victims of abuse, neglect, or domestic violence; health oversight activities (audits, licensure, or disciplinary proceedings); judicial and administrative proceedings pursuant to a court order, warrant, or subpoena; law enforcement purposes; and to avert a serious threat to health or safety.

All Other Situations: Except as otherwise permitted or required, we may not use or disclose your personal health information without your written authorization. You may revoke your authorization at any time, except to the extent we have already taken action in reliance on it.

Miscellaneous: We may contact you to provide appointment reminders or information about treatment alternatives or other health-related services that may be of interest to you.

Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of your personal health information. We are not required to agree to a requested restriction, but if we do, we are bound by it except in certain emergency situations.

Right to Receive Confidential Communications: You have the right to request that we communicate with you by alternative means or at an alternative location.

Right to Inspect and Copy: You have the right to inspect and obtain a copy of your personal health information contained in your designated record set (medical and billing records), with certain exceptions (e.g., psychotherapy notes). We may charge a reasonable, cost-based fee for copies.

Right to Amend: You have the right to request that we amend your personal health information if you believe it is incorrect or incomplete. We may deny the request under certain circumstances, and will explain the basis for any denial in writing.

Right to an Accounting of Disclosures: You have the right to receive a written accounting of disclosures of your personal health information made within the six years preceding your request, with certain exceptions (e.g., disclosures for treatment, payment, and healthcare operations).

Right to a Paper Copy: You have the right to obtain a paper copy of this Notice at any time.