Privacy Policy

Notice of Privacy Practices for Protected Health Information

[45 CFR 164.520]

This notice describes how medical information about you may be used and
disclosed and how you can get access to this information. Please review it carefully.
We use the words “health information” when we mean information that identifies
you. Examples include your name, date of birth, health care you received, or
amounts paid for your care.

We may use and share your health information for the following reasons: To help
take care of you
We may use your health information to help with your health care. We also use it to
decide what services your benefits cover. We may tell you about services you can get.
We may also remind you of appointments. We may share your health information with
other people who give you care. This could be doctors or drug stores. We may use a
private internet website to share your health information with the people who give you
care.

Family and friends
Family and friends: We may share your health information with someone who is helping
you. They may be helping with your care or helping pay for your care. For example, if you
have an accident, we may need to talk with one of these people. If you do not want us to
give out your health information, please let us know. If you are under eighteen and don’t
want us to give your health information to your parents, please let us know. We can help in
some cases if allowed by state law.

For payment
We may give your health information to others who pay for your care. We must give your
insurance company a claim form that includes your health information. We may also use
your health information to look at the care your provider gives you. We can also check
your use of services.

Health care operations
We may use your health information to help us do our job. For example, we may use your
health information for health promotion, case management, quality improvement, fraud
prevention, or legal matters. When you call us with questions we need to look at your
health information to give you answers.

We may share your health information with other businesses. We do this for the reasons
we explained above. For example, you may have transportation covered in your plan. We
may share your health information with them to help you get to the doctor’s o ce. We will
tell them if you are in a motorized wheelchair so they send a van instead of a car to pick
you up.

We also may share your health information for these reasons
Public safety: To help with things like child abuse or threats to public health.Business
partners: To people that provide services to us. They promise to keep your information
safe. Industry regulation: To state and federal agencies. They check to make sure we are
doing a good job. Law enforcement: To federal, state and local enforcement people.Legal
actions: To courts for a lawsuit or legal matter.

Except for what we explained above, we will ask for your okay before using or sharing
your health information. For example, we will get your okay before sharing any
psychotherapy notes or for other reasons as required by law. You can cancel your okay
at any time. To cancel your okay, call us or inform us at your next visit.

What are your rights?
You have the right to look at your health information. You can ask us for a copy of it,
and you can ask for your medical records.

You have the right to ask us to change your health information. You can ask us to change
your health information if you think it is inaccurate. If we don’t agree with the change you
asked for, we will file a written statement of disagreement.