Notice of Privacy Practice for Protected Health Information

How We Use Your Patient Health Information

We use health information about you for treatment, to obtain payment, and for health care operations, 包括管理目的和对你所接受的护理质量的评估. 在某些情况下，我们可能需要在未经您许可的情况下使用或披露您的信息. Examples of Treatment, Payment and Health Care Operations

Treatment:

我们将使用和披露您的健康信息，以便为您提供医疗或十大正规靠谱网赌平台. For example, nurses, 医生和十大正规靠谱网投平台团队的其他成员将在您的病历中记录信息，并使用它来确定最合适的十大正规靠谱网投平台方案. 我们也可能向参与您十大正规靠谱网投平台的其他医疗保健提供者披露这些信息, 给你配药的药剂师和帮助照顾你的家庭成员.

Payments:

We will use and disclose your health information for payment purposes. For example, 在提供某些类型的十大正规靠谱网投平台之前，我们可能需要获得您的保险公司的授权. 我们将提交账单并保存您的健康计划付款记录.

Health Care Operations:

我们将使用和披露您的健康信息来执行我们标准的内部操作, including proper administration of records, 评估十大正规靠谱网投平台质量，评估你的病例和其他类似病例的护理和结果.

Special Uses

We may use your information to contact you with appointment reminders. 我们也可能与您联系，提供您可能感兴趣的十大正规靠谱网投平台方案或其他与健康相关的福利和十大正规靠谱网赌平台的信息.

Other Uses and Disclosures

我们可能会出于其他原因使用或披露您的可识别健康信息, even without your consent. Subject to certain requirements, 出于以下目的，我们可以在未经您许可的情况下提供健康信息:法律要求:法律可能要求我们报告枪伤情况, suspected abuse or neglect or similar injuries or events.

Research:

We may use of disclose information for approved medical research.

Public Health Activities:

As required by law, we may disclose vital statistics, diseases, 与召回危险产品有关的信息以及向公共卫生当局提供的类似信息.

Health oversight:

我们可能会被要求披露信息以协助调查和审计, eligibility for government programs and similar activities.

Judicial and administrative proceedings:

We may disclose vital statistics, diseases, information related to recalls of dangerous products, and similar information to public health authorities.

Law enforcement purposes:

我们可能会根据适当的传票或法院命令披露信息.

Deaths:

We may report information regarding deaths to coroners, medical examiners, funeral directors and organ donation agencies.

Serious threat to health or safety:

我们可能会在必要时使用和披露信息，以防止对您的健康和安全或公众或其他人的健康和安全的严重威胁.

Military and Special Government Functions:

If you are a member of the armed forces, we may release information as required by military command authorities. 我们也可能向惩教机构或出于国家安全目的披露信息.

Workers Compensation:

我们可能会为工伤或疾病补偿或类似的福利项目发布您的信息.

Sign In Sheet:

我们可能会在您到达我们办公室时让您签到，从而使用和披露您的健康信息. We may also call out your name when we are ready to see you.

Website:

If we maintain a website that provides information about our office, this Notice will be on the website.In any other situation, 在使用或披露有关您的任何可识别的健康信息之前，我们将征求您的书面授权. If you chose to sign an authorization to disclose information, 您稍后可以调用该授权来阻止任何进一步的使用和披露.

Individual Rights

You have the following rights with regard to your health information. 请与下面列出的人员联系，以获取行使这些权利的适当表格.

Request Restrictions:

您可以要求限制您的健康信息的某些使用和披露. We are not required to agree to such restrictions, but if we do agree, we must abide by those restrictions.

Confidential Communications:

You may ask us to communicate with you confidentially by, for example, 将通知发送到特定地址或不使用明信片来提醒你的约会.Inspect and Obtain Copies:In most cases, you have the right to look at or get a copy of your health information. There may be a small charge for the copies.

Amend Information:

If you believe that information in your record is incorrect, or if important information is missing, 您有权要求我们更正已有的信息或添加缺失的信息.

Accounting of Disclosures:

您可以要求我们列出我们因十大正规靠谱网投平台以外的原因披露您的健康信息的实例列表, payment or health care operations.

Our Legal Duty

法律要求我们保护和维护您的健康信息隐私，并提供本声明，说明我们在受保护的健康信息方面的法律责任和隐私实践, and to abide by the terms of the Notice currently in effect

Changes in Private Practices

We may change our policies at any time. Before we make a significant change in our policies, we will change our Notice and post the new Notice in the waiting room, you can also request a copy of our Notice at any time. 有关我们的隐私惯例的更多信息，请联系下面列出的人员.

Complaints

If you are concerned that we have violated your privacy rights, or if you disagree with a decision we make about your records, you may contact the person listed below. You may also send a written complaint to the U.S Department of Health and Human Services. 以下人员将根据您的要求提供适当的地址. You will not be penalized in any way for filing a complaint.

Contact Person

If you have questions, requests, or complaints, please contact:

Kristina Calligan
Privacy Officer
1008 E. McDowell Rd. Suite-A
Phoenix, AZ 85006-2603
(602) 358-8588
Effective Date: July 1, 2010

NOTICE OF PRIVACY PRACTICES

To our patients. 本通知描述了如何使用和披露有关您(作为本诊所的患者)的健康信息, and how you can get access to your health information. 这是根据1996年《十大正规靠谱网投平台》(HIPAA)制定的隐私条例所要求的。.

Our Commitment to Your Privacy

我们的做法是致力于维护您健康信息的隐私. 法律要求我们对您的健康信息保密:

在某些特殊情况下使用和披露您的健康信息: