Notice of Privacy Practices

Understanding your Health Record

A record is made each time you are treated at this clinic. Your injuries, evaluation and test results, diagnosis, treatment and a plan of care are recorded. This information is most often referred to as your “health or medical record” and serves as a basis for planning your care and treatment. It also serves as a means of communication among any and all other health professionals who may contribute to your care. Understanding what information is retained in your record and how that information may be used to help you to ensure its accuracy, and enable you to relate to who, what, where, and why others may be allowed access to your health information. This effort is being made to assist you in making informed decisions before authorizing the disclosure of your medical information to others.

Understanding your health information rights

Your health record is the physical property of this clinic but the content is about you and therefore belongs to you. You have the right to request restrictions on certain uses and disclosures of your information and to request amendments to be made to your health record. Your rights include being able to review or obtain a paper copy of your health information, and given an account of all disclosures. You may also request communication of your health information be made by alternative means or to alterative locations. Other than activity that has already occurred you may revoke any further authorizations to use or disclose your health information.

Clinic responsibilities

This clinic is required to maintain the privacy of your health information and to provide you with notice of our legal commitment and privacy practices with respect to the information collected and maintained about you. This clinic is required to abide by the terms of this notice and to notify you if unable to grant your requested restrictions or reasonable desires to communicate your health information by alterative means or to alternative locations. This clinic reserves the right to change its practices and effect new provisions that enhance the privacy standards of all patient health information. In the event that changes are made, this clinic will notify you at the current address provided on your medical file. Other than for reasons described in this notice, this clinic agrees not to use or disclosure your health information without authorization.

For further information

Further information about an individual’s privacy rights can be obtained from the Office of the Federal Privacy Commissioner Private Hotline  1-300-363-992

Your health information will be used for treatment, payment and healthcare operations

Treatment- Information obtained by your therapist in this clinic will be recorded in your medical record and used to determine the course of treatment. This consists of your therapist recording her own expectations and those of others in involved in providing your care. The sharing of your health information may progress to others involved in your care, such as physicians.

Payment- Your healthcare information may be used in order to receive payment for services rendered by this clinic. A bill may be sent to either you or a third party payer with accompanying documentation that identifies you, your diagnosis, procedures performed and supplies used.

Healthcare operations- The medical staff in this clinic may use your health information to assess the care you received and the outcome of your case compared to others like it. Your information may be reviewed for risk management or quality improvement purposes in an effort to continually improve the quality and effectiveness of the care and service provided.

Understanding this clinic's policy for specific disclosures

Notification- Your health record may be used to notify or assist family members, personal representatives, or other persons responsible for your care to enhance your well-being or whereabouts.

Communications with family- Using best judgement, a family member, or close personal friend, identified by you, may be given information relevant to your care and/or recovery.

Workers Compensation- This clinic will release information to the extent authorized by law in matters of workers compensation.

Public Health- This clinic is required by law to disclose health information to public health and/or legal authorities charged with tracking reports of births and morbidity. This clinic is further required by law to report communicable disease, injury or disability.

Law enforcement- (1) Your health information will be disclosed for law enforcement purposes as required under state law or in response to a valid subpoena. (2) Provisions of federal law permit the disclosure of your health information to appropriate health oversight agencies, public health authorities, or attorneys in the event that a staff member or business associate of this clinic believes in good faith that there has been unlawful conduct or violations or professional or clinical standards that may endanger one or more patients, workers or the general public.

Notice of Privacy Practices Availability

The terms described in this notice will be posted where registration occurs. All individuals receiving care will be given a hard copy and asked to acknowledge receipt.