Notice of Privacy Practices Acknowledgment
Site and Practice Privacy
We understand that medical information about you and your health is personal. As the custodians of the information in your medical record, we are committed to protecting the privacy of your information as required by law professional accreditation standards and our internal policies and procedures.
As a patient, you will receive a copy of a Privacy Policy. This notice explains your rights, our legal duties and our privacy practices. It also describes how much medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
For your convenience, the following is a summary of the information discussed in the notice:
- Our Pledge
- Your personal information
- Our Privacy Practices
- Your written permission
- Other restrictions
- Your rights
- Changes
- Questions or Complaints
We may use your information for:
- Treatment
- Health Information Exchange
- Payment
- Health Care Operations
- Notifications
- Marketing Research
- Special circumstance & the law
Please understand that this summary is not our Notice of Privacy Policies, nor is it a substitute for the notice. The actual notice will be provided to you, as required by law, with this cover letter. If it was not, please contact our office manager at the address or phone number above to receive your copy.