HIPPA Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION, PLEASE REVIEW IT CAREFULLY.
WHO WILL FOLLOW THIS NOTICE:
* Any healthcare professional authorized to enter information into your chart, including nurses or other medical professionals.
* Any member of a volunteer group we allow to help while you are in the treatment center.
* All employees, staff and other treatment personnel.
OUR LEGAL DUTY:
We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give this Notice about our privacy practices, and our legal duties and your rights concerning your health information. We must follow the privacy practices that are described in the Notice while it is in effect. The Notice takes effect November 24th, 2003.
USES AND DISCLOSURES OF HEALTH INFORMATION
We use and disclose health information about you for treatment and payment of said treatment.
In addition to our use of your health information for treatment or payment, you may give us written authorization to use your health information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use of disclosures permitted by authorization while it was in effect. Unless you give us a written authorization, we cannot use or disclose your health information for any reason except those described in this notice.
TO YOUR FAMILY
We must disclose your health information to you, as described in the Patient Rights Section of this Notice. We may disclose health information or to disclose it to a family member, friend or other person to the extent necessary to help with your healthcare or with payment for your healthcare, but only if you agree we may do so.
REQUIRED BY LAW
We may use or disclose your health information when we required to do so by law.
PUBLIC HEALTH RISKS:
We may disclose medical information about you for public health activities. These activities generally include the following:
* To prevent control of disease, injury or disability
* to report births or deaths
* to report the abuse or neglect of children, elder and dependent adults
* to report reactions to medications or problems with products
* to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
HEALTH OVERSIGHT ACTIVITIES:
We may disclose health information to a health oversight for activities authorized by law. These oversight activities may include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system and compliance with civil rights laws.
We may release health information if asked to do so by law enforcement official:
* in response to a court order, subpoena, warrant, summons or similar process
* about a victim of a crime if, under certain limited circumstances, we are able to obtain the person's agreement
* about a death we believe may be the result of criminal conduct
* in emergency circumstances to report a crime, the location of a crime or victims, or the identity, description or location of the person who committed the crime.
LAWSUITS AND DISPUTES:
If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. We may also disclose information about you in response to a subpoena, discovery recovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request (which may include written Notice to you) or to obtain an order protecting the information requested.
We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorize federal officials health information required for lawful intelligence, counterintelligence and other national security activities. We may disclose to a correctional institution or law enforcement officials having lawful custody or protected health information of inmate or patient under certain circumstances.
You have the right to look at or get copies of your health information, with limited exceptions. You must make a request in writing to obtain access to your health information. You may obtain a form request access by using the contact information listed in this Notice. We will charge you a reasonable cost based fee for expenses such as copies and staff time. You may also request access by sending us a letter to the address in this Notice.
QUESTIONS AND COMPLAINTS
If you want more information about privacy practices or have questions or concerns, please contact us:
Privacy Officer: David Clark
Telephone # 770-602-1979
Address: 930 Green Street, Conyers, GA 30012
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