Your Information. Your Rights. Our Responsibilities.

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.

“Protected health information“ (PHI) is information about you, including demographic information, that may identify you or be used to identify you, and that relates to your past, present or future
physical or mental health or condition, the provision of health care services, or the past, present or future payment for the provision of health care.

Your Rights Regarding Your PHI
You have the right to:
● Get a copy of your paper or electronic medical record
● Correct your paper or electronic medical record
● Request confidential communication
● Ask us to limit the information we share
● Get a list of those with whom we’ve shared your information
● Get a copy of this privacy notice
● Choose someone to act for you
● File a complaint if you believe your privacy rights have been violated

Our Uses and Disclosures
We may use and share your information as we:
● Treat you
● Run our organization
● Bill for your services
● Help with public health and safety issues
● Do research
● Comply with laws that may be in place now or in the future

Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record
● You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. 
● We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.