Your Information
Your Rights
Our Responsibilities
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.
Patients May:
- Get a copy of your paper or electronic medical record
- Request confidential communication
- Get a list of those with whom we've shared your information
- Get a copy of this privacy notice
- Choose someone to act for you
You have some choices in the way that we use and share information as we:
- Tell family and friends about your condition
- Provide disaster relief
- Provide mental health care
We may use and share your information as:
- Treat you
- Run our organization
- Bill for your services
- Help with public health and safety issues
- Do research
- Comply with the law
- Address law enforcement and other government requests
- Respond to lawsuits and legal actions
When it comes to your health information, you have certain rights.
This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
- You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Request confidential communications
- You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
- We will say "yes" to all reasonable requests.
Get a copy of this privacy notice
- You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
- If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will make sure the person has this authority and can act for you before we take any action.
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:
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
Treat you
- We can 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 organization
- We can 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
Bill you for services
- We can use and share your health information to bill and get payment from health plans or other entities
Example: We give information about you to your health insurance plan so it will pay for your services
How do we typically use or share your health information?
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 follow 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.
Bill you for services
We can share health information about you for certain situations, such as:
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone's health or safety
Do research
- We may use or share your information for health research.
Comply with the law
- We 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.
Address law enforcement and other government requests
We can use or share health information about you:
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
- We can share health information about you in response to a court or administrative order, or in response to a subpoena
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information, except as described here, unless you provide us with written consent. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to 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.
Contact us:
For more information or questions about how we manage your health information, please contact our Privacy Officer at 401-725-3888.
Effective Date of Note: January 16, 2026