This notice describes how health information about you (as a patient of this clinic) may be used and disclosed and how you can get access to your health information. This is required by the Privacy Regulations created as a result of the Health Insurance Portability and Accountability act of 1996 (HIPAA).
Our clinic is dedicated to maintaining the privacy of your health information. We are required by law to maintain the confidentiality of your health information.
Use and disclosure of your health information in certain special circumstances.
The following circumstances may require us to use or disclose your health information: To public health authorities and health oversight agencies that are authorized by law to collect information. Lawsuits and similar proceedings in response to a court or administrative order. If required to do so by a law enforcement official. When necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual in the public. We will only make disclosures to a person or organization able to help prevent the threat. If you are a member of the U.S. or foreign military forces (including veterans) and if required by the appropriate authorities. To federal officials for intelligence and national security activities authorized by law. To correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. For Workers Compensation and similar programs.
You can request that our clinic communicate with you about your health and related issues In a particular manner or at a certain location. For instance, you may ask that we contact you at home rather than at work. We will accommodate reasonable requests.
You can request a restriction in our use or disclosure of your health information for treatment, payment, or healthcare operations. Additionally, you have the right to request that we restrict our disclosure of your health to only certain individuals involved in your care or the payment of your care such as family members and friends. We are not required to agree with your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you.
You have the right to inspect and obtain a copy of the health information that may be used to make psychotherapy notes. You must submit a signed and dated request to: Carpathla Collaboratlve, 10260 N Central Expwy., Ste 210, Dallas, TX 75231.
You may ask us to amend your health information if you believe it is incorrect or incomplete, and as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing to the above address in #3. You must provide us with a reason that supports your request for amendment.
Right to a copy of this notice. You are entitled to receive a copy of this Notice of Privacy Practices. You may ask us to give you a copy at any time by contacting our office at 469-729-6460.
Right to file a complaint. If you believe your privacy rights have been violated, you may file a complaint with the Secretary of the Department of Health and Human Services. To file a complaint with our clinic, please contact our office at 469-729-6460. All complaints must also be submitted in writing to the clinic address. You will not be penalized for filing a compliant.
Right to provide an authorization for other uses and disclosures. Our clinic will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law.
SMS messages will inform the recipient:
• they are consenting to receive messages from the business
• their personal info will not be shared with third parties for marketing purposes
• message frequency: frequency varies
• they may reply STOP (or other keywords) to opt-out of future messaging
• they may reply HELP for more information
• message and data rates may apply
If you have any questions regarding this notice or our health information privacy policies, please contact our office at 615-632-3331.
