Attorney review required. The text below is a structural draft prepared for review. A HIPAA Notice of Privacy Practices is a regulated document and the final version must be reviewed and approved by a licensed healthcare-privacy attorney before publication.
Effective date: [DATE TO BE INSERTED ON REVIEW]
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.
Our duties
JuveFlo (Julian Flores, MD PPLC) is required by law to maintain the privacy of your protected health information ("PHI"), to provide you with this Notice of our legal duties and privacy practices with respect to your PHI, and to abide by the terms of the Notice currently in effect.
How we may use and disclose your PHI
We may use and disclose PHI for treatment, payment, and health-care operations as permitted by HIPAA. Specific examples - including disclosures required by law, public health activities, and disclosures with your authorization - are described in detail in the full notice [TO BE COMPLETED ON REVIEW].
Your rights
You have the right to inspect and obtain a copy of your PHI, request amendments, request restrictions on certain uses and disclosures, request confidential communications, receive an accounting of certain disclosures, and receive a paper copy of this Notice. You may also file a complaint with us or with the U.S. Department of Health and Human Services without fear of retaliation.
Changes to this Notice
We reserve the right to change this Notice. Any change applies to PHI we already have as well as PHI we receive in the future. The current Notice is posted in our office and on this page; the effective date is at the top.
Contact / Privacy Officer
To exercise any right described in this Notice, or to file a complaint, contact our Privacy Officer using the contact information on the contact page.