Reach Out | (678) 635-8564 24/7 Hotline | (800) 712-HELP (4357)
Call Us | (678) 635-8564 24/7 Hotline | (800) 712-HELP (4357)
226 Alcovy St., Suite E-17Monroe, GA 30655
Monday | 9am - 5pm Tuesday | Closed Wednesday | Closed Thursday | 10am - 6pm Friday | 9am - 1pm
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.
You have the right to:
You have some choices in the way that we use and share information as we:
We may use and share your information as we:
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we never share your information unless you give us written permission:
How do we typically use or share your health information?
We use or share your health information in the following ways:
Treat youWe use your health information and share it with other professionals who are treating you.Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organizationWe use and share your health information to run our practice, improve your care, and contact you when necessary.Example: We use health information about you to manage your treatment and services. How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations such as:
Do researchWe can use or share your information for health research.
Comply with the lawWe will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law. Respond to organ and tissue donation requestsWe can share health information about you with organ procurement organizations. Work with a medical examiner or funeral directorWe can share health information with a coroner, medical examiner, or funeral director when an individual dies. Address workers’ compensation, law enforcement, and other government requestsWe can use or share health information about you:
Respond to lawsuits and legal actionsWe can share health information about you in response to a court or administrative order, or in response to a subpoena.
For more information: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
HHS Model Form, http://www.hhs.gov/ocr/privacy/hipaa/modelnotices.html