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Summary of Privacy Practices

This summary of our privacy practices is a condensed version of our Notice of Privacy Practices. You can download our full-length Notice here.

Date of Last Revision: 9/1/2013

Effective Date: Immediately

This information is made available on request by a patient.

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 understand that your medical information is personal to you, and we are committed to protecting the information about you. As our patient, we create medical records about your health, our care for you, and the services and/or items we provide to you as our patient. By law, we are required to make sure that your Protected Health Information is kept private.

How will we use or disclose your information? Here are a few examples (for more detail, please refer to our full-length Notice of Privacy Practices):

  • For medical treatment
  • To obtain payment for our services
  • In emergency situations
  • For appointment and patient recall reminders
  • To run our Practice more efficiently and ensure all our patients receive quality care
  • For research
  • To avert a serious threat to health or safety
  • For organ and tissue donation
  • For workers’ compensation programs
  • In response to certain requests arising out of lawsuits or other disputes

If you believe your privacy rights have been violated, you may file a complaint with the Practice or with the Secretary of the Department of Health and Human Services. To file a complaint with the Practice, contact our Practice Administrator, Lewis Bergman. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

You have certain rights regarding the information we maintain about you. These rights include:

  • The right to inspect and copy
  • The right to amend
  • The right to an accounting of disclosures
  • The right to request restrictions
  • The right to a paper copy of this notice
  • The right to request confidential communications

For more information about these rights, please download our full Notice of Privacy Practices.

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