MY PLEDGE REGARDING MEDICAL INFORMATION: I understand that medical information about you and your health is personal. I create a record of your health and wellness history and the care and services you receive. This record is needed to provide you with quality care and to comply with certain legal requirements.
This notice applies to all of the records of your care generated by Janenaturopath, whether made by myself or by your personal doctor and passed on to me. This notice will tell you about the ways in which I may use and disclose protected health information, described in this notice as medical information, about you. I also describe your rights and certain obligations we have regarding the use and disclosure of medical information.I am required by law to:
- Ensure that medical information that identifies you is kept private
- Notify you of any breach of unsecured protected health information about you
- Give you this notice of my legal duties and privacy practices with respect to medical information about you
- Follow the terms of the notice that are currently in effect
HOW I MAY USE AND DISCLOSE PERSONAL INFORMATION ABOUT YOU: The following categories describe different ways that I may use and disclose medical information based on your consent.
- For Treatment. I may use medical information about you to provide you with medical treatment or services from myself or a third party practitioner
- For Payment. I may use and disclose medical information about you so that the treatment and services you receive from me may be billed to, and payment may be collected from you, or an insurance company or a third party. For example, your health plan may request information about services you received in order to reimburse or pay for such services.
- Appointment Reminders, Treatment Alternatives, and Health-Related Benefits and Services. I may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care. Also, it may be used to tell you about or recommend possible treatment options or alternatives that may be of interest to you, or to tell you about health-related benefits or services that may be of interest to you.
- Individuals Involved in Your Care or Payment for Your Care. I may release medical information about you to friends or family members who are involved in your medical care. I may also give information to someone who helps pay for your care. If possible, I will ask your permission prior to discussing your care with others, as you may wish to object to this disclosure.
- Individuals Designated as Your Personal Representative. I may release medical information about you to the person who has legal authority to act on your behalf in making decisions related to your health care, when you are unable to do so.
- To Avert a Serious Threat to Health or Safety. I may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or to the health and safety of the public or another person. Any disclosure, however, would only be in order to prevent the threat.
- Public Health. I may disclose medical information about you for public health activities. These activities generally include items such as:
- To prevent or control disease, injury or disability
- To report suspected abuse or neglect
Right to Confidential Communications. You have the right to request that I communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that I only contact you at work or by mail. To do so please inform me.
Your information will be kept securely, be available to you at all times and will never be shared (given the exceptions outlined above) without your express permission.