Notice of Privacy Practices

We are required by the Health Insurance Portability & Accountability Act (HIPAA) Privacy Rule to provide a “Notice of Privacy Practices” to inform you about:

  • How your medical information may be used and disclosed
  • How you can get access to your health information

We are also required, by law, to state in writing that you received the notice:

  • The law does not require you to sign the “Acknowledgement of receipt of notice of Notice of Privacy Practices”.
  • Signing the acknowledgment does not mean that you have agreed to any special uses or disclosures (sharing) of your health records.
  • Refusing to sign the acknowledgement does not prevent us from using or disclosing health information as HIPAA permits.
  • If you refuse to sign the acknowledgement, we must keep a record of this fact.

Following is a summary our Notice of Privacy Practices:

Your Rights:
  • Get an electronic or paper copy of your medical record.
  • Ask us to correct your medical record.
  • Request confidential communications.
  • Ask us to limit what we use or share.
  • Get a list of those with whom we have shared information.
  • Get a copy of this Privacy Notice.
  • Choose someone to act for you.
  • File a complaint if you feel your rights are violated.
Your Choices
  • For certain health information you can tell us your choices about what we share.
  • In some cases, we never share your information unless you give us written permission.
Our Uses & Disclosures
  • Treat you.
  • Run our organization.
  • Bill for your services.
  • Help with public health and safety issues.
  • Do research.
  • Comply with the law.
  • Respond to organ & tissue donation requests.
  • Work with medical examiner or funeral director.
  • Address workers’ compensation, law enforcement and other government requests.
  • Respond to lawsuits and legal actions.
Our Responsibilities
  • Maintain privacy and security of your PHI.
  • Advise you of breaches that might compromise your PHI.
  • Follow the duties & practices of this notice.
  • Not use or disclose your information other than as prescribed

Where You Can Find Our “Notice of Privacy Practices”

Our Notice of Privacy Practices can be found:

  • Located in this Client Handbook
  • Posted in our Agency office; and/or,
  • Displayed on patient online knowledgebase

You will receive a Notice of Privacy Practices:

  • Usually at your initial assessment
  • In an urgent situation, you will receive notice as soon as possible after the event.

Anyone may request to see our Notice of Privacy Practices.

Apr 10, 2022

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