Notice of Privacy Practices

This clinic is committed to providing you with high quality healthcare and to forming a relationship with you that is built on trust. That means respecting your privacy and confidentiality of your medical information. We protect your privacy and confidentiality rights by creating and putting into practice policies and procedures that allow access to your personal medical information only for legitimate reasons.

Your health record

As we provide your health care, we are required to maintain a complete copy of your history, current condition, treatment plan and all treatment given, including the results of all tests, procedures and therapies. Whether this information is stored in writing, on a computer or by other means, we will keep this information in a safe and secure way that protects your privacy, and confidentiality. We are HIPAA Compliant relative to confidentiality of health care information.

Your medical/behavioral health information is private and confidential

You, or anyone to whom you give written permission, or your legal representatives, have the right to read or get a copy of your medical information. Your medical record is the physical property of this clinic. There are exceptions to this policy. If your services are being paid for by a workers’ compensation carrier, MVA carrier or are related to a disability evaluation, the records then are available to these entities as required by law. Specific issues of criminal acts, abuse, neglect and/or violence requires considerations for safety of the parties involved and may require reporting to the appropriate legal authorities.

We also work in close coordination with your health care provider/physician with whom it is important to share information for your on-going care. We will ask you to sign a release of information form to allow for this coordination of care.

How do we assure your privacy?

This clinic has put in place detailed policies regarding access to medical records by our staff and employees and has carefully outlined the circumstances under which your medical information may be released to parties outside this clinic. These policies conform to state and federal law and are designed to safeguard your privacy. Our staff and employees are trained in the appropriate use of medical information and know that it is available to them only to continue to provide care to you or for other limited but legitimate reasons. A violation of confidentiality or the failure of an employee to protect your information from accidental or unauthorized access will not be tolerated. This may include the employee being fired from his or her job.

We ask for your permission

We do not allow others outside this clinic to access your medical information unless we have the appropriate authorization to do so. We will request your authorization to release information at your first appointment. In addition, some laws prevent certain types of information from being released without specific patient permission. Examples include, but are not limited to: Confidential details of psychotherapy notes (from therapy notes — not chart notes by a psychologist and clinical social worker; also other records Domestic violence victims’ counseling, Sexual assault counseling, HIV test results (patient authorization required for EACH release request), Sexually-Transmitted diseases; Alcohol and drug abuse treatment).

Please note, however, that the law requires some information to be disclosed in certain circumstances

This includes mandatory reports of abuse. Also, subpoenas or court orders may compel the disclosure of confidential or privileged health information in the context of a lawsuit or administrative proceeding. Health care records are sometimes used for reasons other than patient care. For example, records are periodically reviewed to evaluate the quality of care or to be sure that this clinic follows the rules of regulatory agencies and insurance companies for the efficient and effective utilization of care such as Medicare, Department of Public Health, Department of Mental Health, etc.

Your insurance company may request information that we are required to submit in order to provide and bill for your care. Anyone reviewing records must follow the same confidentiality laws and rules required of all health care providers. If you have questions about the privacy of your medical records, please speak with us. We will be happy to help you.