This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review carefully.

Under the Health Insurance Privacy & Portability Act of 1996 “HIPPA” it is our legal duty to safeguard your
Protected Health Information (PHI). Please note that we reserve the right to change the terms of the Notice and our privacy policies at any time as permitted by law. Any changes will apply to PHI already on file with us. Before we make any important changes to our policies, we will immediately change this Notice and post a new copy of it on our website and in our office. This notice will remain in effect until it is replaced or amended.

During the course of our relationship with you, we will use and disclose PHI about you for treatment, payment, and
healthcare operations. We gather personal information and health information from you, other healthcare providers, and third party payers. Use of PHI means when we share, apply, utilize, examine, or analyze information within our practice; PHI is disclosed when we release, transfer, give, or otherwise reveal it to a third party outside our practice. You may specifically authorize us to use PHI for any purpose or to disclose our health information by submitting the authorization in writing. Such disclosures will be made to any personal representative you choose to grant access to your PHI.

This office will not use or disclose your PHI for marketing communications without your written authorization. This
office may send birthday cards, thank you cards, notice of clinic events, newsletters, and/or appointment reminders by email, US mail or other means as appropriate.

Social Media Engagement
This office does engage with patients and non-patients alike on social media platforms, recognizing that platforms we participate in typically provide for a means to “disconnect”, “unfriend”, or “block” interaction with our office at will. We do not abuse our online participation and will not divulge an individual’s status with our office or any PHI online under any circumstances. We may privately ask for a review or a testimonial from past or current patients to allow others to learn about us, but patient response is always voluntary. We cannot control how publicly posted information is handled by 3rd parties and so we recommend that no personal or private information should ever be posted online.

This office may use or disclose your PHI without your consent or authorization when required by law.

Patient Rights
1. Upon written request, you have the right to review and receive copies of your PHI
2. Upon written request, you have the right to receive a list of disclosures about your PHI.
3. You have the right to request additional restrictions on the use and disclosure of your PHI, permitted by law.
4. Upon written request, and as permitted by law, you have the right to request that we amend your PHI.
5. You have the right to receive all notices in writing.

If you have questions about this Notice or any complaints about our privacy, please contact our office. Please send written complaints to the Secretary of the Department of Health & Human Services, 200 Independence Ave. S.W. Washington, D.C. 20201.

This Notice went into effect April 14, 2003.


Edited on 12/6/2018