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Our Responsibilities
The office/hospital is required to:
· Maintain the privacy of your health information as required by law;
· Provide you with a notice as to our duties and privacy practices as to the
information we collect and maintain about you;
· Abide by the terms of this Notice;
· Notify you if we cannot accommodate a requested restriction or request; and,
· Accommodate your reasonable requests regarding methods to communicate health
information with you.
We reserve the right
to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding
the protected health information we maintain. If our information practices change,
we will amend our Notice. You are entitled to receive a revised copy of the Notice
by calling and requesting a copy of our "Notice" or by visiting our office and picking up a copy.
To Request Information or File a Complaint
If you have questions,
would like additional information, or want to report a problem regarding the handling of your information, you may contact
the Office Manager,
Additionally, if you
believe your privacy rights have been violated, you may file a written complaint at our office by delivering the written complaint
to the Office Manager. You may also file a complaint by mailing it or e-mailing it to the Secretary of Health and Human Services,
whose street address and e-mail address is: Office for Civil Rights - U.S. Department
of Health and Human Services -
· We cannot, and will not, require you to waive the right to file a complaint
with the Secretary of Health and Human Services (
· We cannot, and will not, retaliate against you for filing a complaint with
the Secretary of Health and Human Services.
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