You have the right to:
- Obtain a paper or electronic copy of your medical record: You can ask to see or obtain an electronic or paper copy of your medical record and other health information we have about you.
- Correct inaccuracies on your medical record: You can ask us to correct health information about you that you think is incorrect or incomplete.
- Request confidential communication: 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.
- Ask us to limit the information we share: You can ask us not to use or share certain health information about your treatment, payment, or our operations. However, if not sharing that information would affect your care, we have the right to deny this request.
- Access a list of those with whom we’ve shared your information: You can ask for details of when we’ve shared your health information, who we shared it with, and why.
- Select someone to act on your behalf: 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.
- File a complaint if you believe your privacy rights have been violated: 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.
- For certain health-related information, you can tell us what you’d like us to share. Let us know if you have a preference for how we share your information in the situations described below.
In the following situations, you have both the option and the right to request that we:
- Share information with family, friends, or others involved in your care
- Share your information in a disaster relief situation
We may need to share your information if there’s a serious and imminent threat to your health or safety.
In the following situations, we will never share your information unless you provide us with written permission:
- For marketing purposes
- To sell your information
Our Uses and Disclosures
- We can share your health information with other professionals who are providing treatment services for you.
- We can share your health information to improve your care and contact you when necessary.
- We can share your health information to bill and get payment from health insurance plans or other entities.
- We are allowed or required to share your information to contribute to the public good, such as public health and research. We have to meet many legal conditions before sharing your information for these purposes. For more information, please visit www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
- We can share your health information under certain circumstances including to prevent disease, help with product recalls, report adverse reactions to medications, report suspected abuse or domestic violence, and prevent or reduce serious threats to health and safety
- We can share your information for health research
- We can share your health information with organ procurement organizations for the purpose of responding to organ and tissue donation requests
- We can share health information with a coroner, medical examiner, or funeral director upon your death
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services to confirm compliance with federal privacy laws.
To address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
- For workers’ compensation claims
- For law enforcement purposes or with law enforcement officials
- 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 health information about you in response to a court or administrative order, or in response to a subpoena.
- We are required by law to maintain the privacy and security of your health information.
- We will inform you immediately if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice.
- We will not use or share your information other than as described here unless you approve it in writing. You may change your mind about this at any time.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
- We can change the terms of this notice, and the changes will apply to all information we have about you.
- Effective March 2021
- Contact us at Drrobinkroll@gmail.com for any additional questions or concerns you may have.