Notice of Privacy Practices
This notice describes how your health information may be used and disclosed
and how you can access this information, Please review carefully.
- We have always kept your health information secure and confidential. A new
law requires us to continue maintaining your privacy, to give you this notice
and to follow the terms of this notice.
- The law permits us to use or disclose your health information to those involved
in your treatment. For example, a review of your file by a specialist doctors
whom we may involve in your care.
- We may use or disclose your health information for payment of your services.
For example, we may send a report of your progress to your insurance company.
- We may use or disclose your health information for our normal healthcare
operations. For example, one of our staff will enter your information into
our computer.
- We may share your medical information with our business associates, such
as a billing service. WE have a written contract with each business associate
that requires them to protect your privacy.
- We may use your information to contact you. For example, we may send newsletters
or other information.
- We may also want to call and remind you about appointments. If you are not
home, we may leave this information on your answering machine or with the
person who answers the telephone.
- In case of emergency, we may disclose your health information to a family
member or another person responsible for your care.
- We may release some or all of your health information when required by law.
- If this practice is sold, your information will become the property of the
new owner.
- Except as described above, this practice will not use or disclose your health
information without your prior written authorization.
- You may request in writing that we not use or disclose your health information
as described above. we will let you know if we can fulfill your request.
- You have the right to know of any uses or disclosures we make with your
health information beyond the above normal uses.
- As we will need to contact you from time to time, we will use whatever address
or telephone number you prefer.
- You have the right to transfer copies of your health information to another
practice. We will mail your files for you.
- You have the right to see and receive a copy of your health information,
with a few exceptions. Give us a written request regarding the information
you want to see. If you want a copy of your records, we may charge you a reasonable
fee for the copies.
- You have the right to request an amendment or change to your health information.
Give us your request to make changes in writing. If you wish to include a
statement in your file, please give it to us in writing. We may or may not
make the changes you request, but will be happy to include your statement
in your file. If we agree to an amendment or change, we will not remove nor
alter earlier documents, but add new information.
- You have the right to receive a copy of this notice. If we change any of
the details of this notice, we will notify you of the changes in writing.
You may file a complaint with the Department of Health and Human Services,
200 Independence Avenue, S.W. Room 509F, Washington DC 20201. You will be not
retaliated against for filing a complaint.
However, before filing a complaint, or for more information or assistance regarding
your health information privacy, please contact our Privacy Officer, Sheri Kinney
RDA, (818) 597-0100
This notice goes into effect as of April 14, 2003.
Last Updated: 4/15/2003