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PATIENT PRIVACY it with and why. We will include Services Office for Civil Rights by in your best interest. We may also share • Bill for your services. We can use and • Reporting adverse reactions to We can use or share your health PATIENT PRIVACY
Example: We use health information
about you to manage your
medications
all the disclosures except for those
sending a letter to 200 Independence
your information when needed to lessen
information:
treatment and services.
Avenue, S.W., Washington, D.C.
a serious and imminent threat to health
• Reporting suspected abuse, neglect
about treatment, payment, and
• For workers’ compensation claims
or domestic violence
• For law enforcement purposes or
20201, calling 1-877-696-6775, or
healthcare operations, and certain
or safety.
share your health information to
with a law enforcement official
• Preventing or reducing a serious
visiting www.hhs.gov/privacy. We
other disclosures (such as any you
bill and get payment from health
will not retaliate against you for
asked us to make). We’ll provide one
• With health oversight agencies for
threat to anyone’s health or safety
In these cases we never share your
activities authorized by law
filing a complaint.
accounting a year for free, but will
plans or other entities. Example: We
• Do research. We can use or share
information unless you give us
charge a reasonable, cost-based fee
your information for health research.
if you ask for another one within 12
health insurance plan so it will pay
such as military, national security,
• Marketing purposes
can tell us your choices about what
for your services.
months. For certain health information, you written permission: give information about you to your • Comply with the law. We will share • For special government functions
information about you if state or
and presidential protective services
• Sale of your information
we share. federal laws require it, including • Respond to lawsuits and legal
Get a copy of this privacy notice. If you have a clear preference for how we • Most sharing of psychotherapy notes We are allowed or required to share with the Department of Health and actions We can share health
share your information in the situations • We may contact you for fundraising your information in other ways – Human Services if it wants to see that information about you in response to
Choose someone to act for you. described below, tell us what you efforts, but you can request not to be usually in ways that contribute to the we’re complying with federal privacy a court or administrative order, or in
• If you have given someone medical want us to do, and we will follow your contacted further. public good, such as public health and law. response to a subpoena.
power of attorney or if someone is instructions. In these cases, you have both research. • Respond to organ and tissue
your legal guardian, that person the right and choice to tell us to: We typically use or share your health • We have to meet many conditions donation requests. We can share We are required by law to maintain
can exercise your rights and • Share information with your family, information in the following ways. in the law before we can share your health information about you with the privacy and security of your
make choices about your health close friends, or others involved in • Treat you. We can use your health information for these purposes. For organ procurement organizations. protected health information.
information. your care information and share it with other more information see: www.hhs. • Work with a medical examiner or • We will let you know promptly if
• Share information in a disaster relief gov/ocr/privacy/understanding/ a breach occurs that may have
File a complaint if you feel your rights situation professionals who are treating you. consumers/index.html. funeral director. We can share health compromised the privacy or security
are violated. • Include your information in a Example: A doctor treating you for information with a coroner, medical of your information.
• You can complain if you feel we have hospital directory an injury asks another doctor about We can share your health information examiner or funeral director when • We must follow the duties and
violated your rights by contacting If you are not able to tell us your your overall health condition. for certain situations such as: an individual dies. privacy practices described in this
the Privacy Officer at 337-528-7891. preference, for example if you are • Run our organization. We can use • Preventing disease • Address workers’ compensation, law notice and give you a copy of it.
You can file a complaint with the U.S. unconscious, we may go ahead and and share your health information to • Helping with product recalls enforcement, and other government n We will not use or share your
Department of Health and Human share your information if we believe it is run our practice, improve your care, requests. information other than as described
and contact you when necessary.
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