As our patient we want you to know we respect the privacy of your Personal Health Information (PHI) and will do all we can to secure and protect it. It is our policy to properly determine appropriate uses of PHI in accordance with the government rules, laws, and regulation. When it is appropriate and necessary, we provide the minimum necessary information only to those we feel are in need of it regarding treatment, payment, or health care operations, in order to provide health care in your best interests. Under the law, they are not required to obtain patient consent to use this information.
You may refuse to consent to the use or disclosure of your personal health information, but this must be provided to us in writing. Under the HIPAA laws, we have the right to refuse to treat you should you choose to refuse to disclose your PHI.
By signing below you acknowledge that you have read and understand the notice of privacy practices and all policies escribed above.