Privacy Policy & HIPAA Compliance
Our Notice of Privacy Practices provides information about how we may use or disclose protected health information. The terms of the notice may change, and if so, you will be notified at your next visit to review changes and update your signature.
You have the right to restrict how your protected health information is used and disclosed for treatment, payment, or healthcare operations. We are required by law to maintain the privacy of, and provide individuals with, this notice of our legal duties and privacy practices with respect to protected health information in accordance to The HIPAA (Health Insurance Portability and Accountability Act of 1996) law which allows for the use of the information for treatment, payment, healthcare operations.
By providing this information, we are giving notice and offering you to consent to our use and disclosure of your protected healthcare information and potentially anonymous usage in a publication. You have the right to revoke this consent in writing, signed by you. However such a revocation will not be retroactive.
Signature below is acknowledgment that you have received this Notice of our Privacy Practices and shows you understand that:
Protected health information may be disclosed or used for treatment, payment or healthcare operations.
The practice reserves the right to change the privacy policy as allowed by law.
The practice may condition receipt of treatment upon execution of this consent.
Last updated, 17Oct2022