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Privacy Policy

The Vertigo Doctor Privacy Policy

Your privacy is important to us

Oak Physical Therapy & Wellness PC and thevertigodoctor.com Privacy Policy

PLEASE READ THIS PRIVACY POLICY CAREFULLY AND IN ITS ENTIRETY BEFORE USING thevertigodoctor.com (HEREINAFTER REFERRED TO AS THE “SITE”). 

This Privacy Policy is here to better serve those who are concerned with how their information is used online. The following describes what type of information we collect, what it’s used for, and the measures we take to protect it.

IMPORTANT NOTE: By using the Site and/or purchasing, viewing, downloading, or otherwise signing up to receive Oak Physical Therapy & Wellness PC email list newsletter, social media posts, blog posts, courses, coaching services, guides, eBooks, forms, worksheets, workbooks, website materials, and/or membership program (hereinafter collectively referred to as the “Site, Courses, Services, and/or Products”), you voluntarily agree to be bound by this Privacy Policy. 

If you have any questions about this Privacy Policy, please contact Madison Oak at [email protected]

If you do not agree with the terms of this Privacy Policy, do not use or browse the Site. 

  • Definitions

“Company”, “We”, “I”, “Our”, or “Us” means Oak Physical Therapy & Wellness PC  and www.thevertigodoctor.com. 

“Content” means any and all written, visual, video, or audio information contained on the Site, including, but not limited to, any and all emails received from Madison Oak,  Oak Physical Therapy & Wellness PC, or thevertigodoctor.com, and any and all written or downloadable material purchased, viewed, or otherwise offered on thevertigodoctor.com, such as blog posts, graphics, designs, documents, information, templates and materials.

“Personal Information” means information that can be used on its own or in conjunction with other information to identify, contact, or locate a person, or to identify an individual in context. For example, personal information includes, among other things, your name, address, email address, telephone number, credit card information, site behavior, etc.

“Site, Courses, Services, and/or Products” means thevertigodoctor.com, Content, email list, social media posts, blog posts, courses, coaching services, guides, eBooks, forms, worksheets, workbooks, website materials, and/or membership programs available on the Site.

“Site” means thevertigodoctor.com and any and all of the Company’s associated pages, tabs, landing pages, forms, or sub-pages.

“You” or “Your” means the user, customer, or viewer of the Site.

  1. Company Statement:

The Site and its Content are owned by  Oak Physical Therapy & Wellness PC and/or Madison Oak.

Oak Physical Therapy & Wellness PC  is committed to protecting your Personal Information. We will only collect or use your Personal Information in accordance with the Privacy Policy herein.

  1. What kind of Personal Information do we collect?

Personal Information You Provide: 

When using the Site, and in filling out forms, purchasing products, providing comments, or contacting us, you may be asked to enter your name, email address, website address, mailing address, payment or credit card information. We use this information to deliver the product purchased, or information requested, to improve the performance and applicability of the Site, and to provide you with educational content, newsletters, promotions, and special offers. 

Personal Information Automatically Collected:

Through use of the Site, the Company may use data collection technology, such as: Google Analytics, Jetpack, Meta (hereinafter referred to as the “Data Collection Companies”) to collect information related to your use of the Site. Generally speaking, this includes information about your geographic location and Site behavior. The Data Collection Companies also provide us with information about what type of device or software you use, your IP address (with location information), and whether you view the Site on mobile, tablet, or desktop.

We collect this information for statistical purposes only and to improve the viewer experience.

  1. What if the Personal Information we have about you is incorrect or you want to update it?

If the Personal Information we have collected about you is incorrect or incomplete in any way, or you would like to update what we have, please contact Madison at [email protected]. We will make the appropriate corrections when notified, as long as the corrections requested to be made are not incorrect or fraudulent in any way.

  1. When do we collect Personal Information?

We collect Personal Information from you when you purchase, order, or sign up on and for the Site, Courses, Services, and Products, download our freebies or resources, subscribe to our newsletter, fill out a form, browse the Site, view Content, make purchases, and/or enter any of your Personal Information on the Site. If you’re just viewing the Site, you won’t be required to provide personal information to browse.

If you’re outside of the EU: if you sign-up to receive any freebies, downloads, webinars, recordings, courses, or services from the Company, or purchase any products or services from us, you will automatically be added to our email list to receive free email messages from us. You can unsubscribe at any time by clicking “UNSUBSCRIBE” at the bottom of each email. If you have any questions, or difficulty unsubscribing from those emails, email Madison at madis[email protected] to be unsubscribed from future messages.

If you’re IN the EU: if you sign-up to receive any freebies, downloads, webinars, recordings, courses, or services from the Company, or purchase any products or services from us, you will only be added to our email list to receive free email messages from us if you affirmatively consent to receiving such messages. You can unsubscribe at any time by clicking “UNSUBSCRIBE” at the bottom of each email. If you have any questions, or difficulty unsubscribing from those emails, email Madison at [email protected] to be unsubscribed from future messages.

  1. How do we use your Personal Information?

When using the Site, Courses, Services, and/or Products, we may use the Personal Information we collect from you when you register, make a purchase, sign up for our newsletter, respond to a survey or marketing communication (typically by email), browse the Site, or use certain other Site features in the following ways:

  • To personalize your experience and to allow us to deliver the type of content and product offerings in which you are most interested.
  • To improve our Site in order to better serve you.
  • To allow us to better serve you in response to your customer service requests.
  • To administer a contest, promotion, survey, or other Site feature.
  • To quickly process your transactions on and for the Site, Courses, Services, and/or Products.
  • To send periodic emails regarding the Site, Courses, Services, and/or Products.
  • To tailor social media (i.e., Facebook, Instagram, etc.) advertisements to you.
  1. Do we share your Personal Information with anyone?

In general, we DO NOT sell, trade, or otherwise transfer to outside (third) parties your Personal Information for marketing or advertising purposes, except for the following purposes:

  • in order to comply with an investigation, law enforcement inquiry, government entities, courts, or other third parties as required or allowed by applicable law, such as for legal and/or safety purposes.
  • Third-party service providers that provide products, tools, platforms or services to us, such as email-list building, website management, customer service, account maintenance, and performing other activities and services related to the management and running of our company.
  • Social media platforms, such as Facebook, Instagram, Twitter, Pinterest, etc. that offer functionalities and services to use their services through our website (i.e., pinning an image to Pinterest, sharing a link to Facebook). If you use those functionalities on the Site, your information will be shared with those platforms to complete those functions and activities. 
  • Third-party advertising purposes, such as advertising on social media platforms (i.e., Facebook and Instagram) to track and categorize your interests and behavior on our Site for the purposes of marketing and advertising to you. We share information with these companies, and these companies may collect information, including your actions taken on the Site, through tracking methods such as Cookies. These third-parties may also possess or get information about you from your behavior/actions: directly with the third-parties; on/from other websites, mobile apps, or companies that the third-party companies work with; or from your interactions with advertisements the third-party companies show you. The information that these companies collect or that we share may be used to customize or personalize the advertisements that are displayed to you.

We may disclose your Personal Information to our subsidiaries, contractors, subcontractors, assigns, affiliates or successors in interest when necessary to carry out our business functions.  This may include website hosting partners and other parties who assist us in operating our website, email service, conducting our business, or serving our users, so long as those parties agree to keep this information confidential. 

However, non-personally identifiable visitor information may be provided to other parties for marketing, advertising, or other uses. If you make your personal information available to third parties through our Site, Courses, Services, and/or Products, Oak Physical Therapy & Wellness PC s not responsible for any unauthorized use by that third party.

It’s also important to note that we DO allow third-party behavioral tracking.

  1. How do we protect your Personal Information?

We aim to make your visit to our Site as safe as possible. The Site uses commercially acceptable methods of security protection to protect your information. [IF YOU USE SECURITY SCANS TO CHECK FOR MALWARE ON YOUR SITE: The Site is scanned for security breaches using, for example, malware removal software.

We also use a SSL certificate and never transmit your credit card information by email.

Your Personal Information is contained behind secured networks and is only accessible by a limited number of persons who have special access rights to such systems, and are required to keep the Personal Information confidential. By viewing, using, or purchasing on or from the Site, Courses, Services, and/or Products, you acknowledge that  Oak Physical Therapy & Wellness PC and its staff and independent contractors may access your Personal Information.

In addition, all sensitive credit card or payment information you supply is encrypted via Secure Socket Layer (SSL) technology.

We implement a variety of security measures when a user places an order to maintain the safety of your Personal Information. All transactions are processed through a gateway provider and are not stored or processed on our servers.

  1. Do we use ‘cookies’ or social media pixels?

Cookies. We, and third-parties as described in Section 7 herein, use cookies and collect information from the computer, mobile phone, or other device you use to access the Site, read our emails, or view our advertisements. This information is automatically collected. Cookies are small data files that a site or its service provider transfers to your computer’s hard drive through your Web browser (if you allow) that enables the site or service provider’s systems to recognize your browser and capture and remember certain information. For instance, we use cookies to help us remember and process the items in your shopping cart. They are also used to help us understand your preferences based on previous or current Site activity, which enables us to provide you with improved services. We also use cookies to help us compile aggregate data about Site traffic and Site interaction so that we can offer better site experiences and tools in the future.

We use cookies to:

  • Help remember and process the items in the shopping cart.
  • Compile aggregate data about site traffic and site interactions in order to offer better Site experiences and tools in the future. We may also use trusted third-party services that track this information on our behalf.
  • To personalize your experience and better understand customers’ preferences for our marketing and business purposes.

You can choose to have your computer warn you each time a cookie is being sent, or you can choose to turn off all cookies. You do this through your browser settings. Since each browser is a little different, look at your browser’s Help Menu to learn the correct way to modify your cookies.

While you may disable the use of cookies through your browser’s settings or options page, you may lose some of the features and functionality of the Site, Courses, Services, and/or Products, as cookies are necessary to help track and enhance your experience on the Site.

Pixels. YES. The Company DOES USE social media pixels (Facebook pixels) to track visitors to the Site so we can tailor advertisements towards those visitors on various social media platforms, including: Facebook and Instagram. The Company reserves the right to use pixels in accordance with the terms of the social media platform.

  1. Third-Party Links:

Occasionally, at our discretion, we may include or offer third-party products, services, or links to articles/blogs/sites on our Site. These third-party sites may or may not have separate and independent privacy policies. We, therefore, have no responsibility or liability for the content and activities of these linked sites and/or their privacy policy (or lack thereof). Nonetheless, we seek to protect the integrity of our Site and welcome any feedback about any issues you experience with linked-to sites by emailing us at [email protected]

  1. Password Privacy:

While using the Site, Courses, Services, and/or Products, you may create a username and/or password for login. It is your responsibility to keep the username and password safe. You are also responsible for any actions which occur through the use of your username/password, whether completed by you directly or through the use of your account. You shall notify us immediately by email at [email protected] of any unauthorized use of your login information or any other security breach. Please log out at the end of each session to prevent any unauthorized use of your account or login information.  

You may not share your username/password or login information with anyone other than yourself. We are not responsible or liable for any loss or damages as a result of your failure to protect your login information or your unauthorized sharing of same.

12.Google Ads & Analytics:

Google’s advertising requirements can be summed up by Google’s Advertising Principles. They are put in place to provide a positive experience for you. We are not currently using Google Ads on the Site, although this may change in the future.

We have implemented the following through Google Analytics: Demographics and Interests Reporting. 

We, along with third-party vendors such as Google, use first-party cookies (such as the Google Analytics cookies) and third-party cookies (such as the DoubleClick cookie) or other third-party identifiers together to compile data regarding user interactions with ad impressions and other ad service functions as they relate to our website.

To Opt-Out of Google Ads: You can set preferences for how Google advertises to you using the Google Ad Settings page. Alternatively, you can opt-out by visiting the Network Advertising Initiative Opt-Out page or by using the Google Analytics Opt-Out Browser add-on.

  1. California Online Privacy Protection Act (“CalOPPA”):

CalOPPA stretches well beyond California to require any person or company that operates websites collecting Personal Information from California viewers/consumers to post a conspicuous privacy policy on its website stating exactly the information being collected and those individuals or companies with whom it is being shared. Read more about CalOPPA here.

Pursuant to CalOPPA, we agree to the following:

Users CAN visit our site anonymously. 

There IS a link to this Privacy Policy on the footer of each page. 

Our Privacy Policy link DOES include the word ‘Privacy’ and can easily be found on the page specified above. It is titled “Privacy Policy” very clearly.

You will be notified of any Privacy Policy changes on our Privacy Policy Page (see bottom “Updated On” date).

  1. Children’s Online Privacy Protection Act (“COPPA”):

We do not specifically market to children under the age of 13. Please STOP and do not use, view, purchase, or otherwise browse the Site, Courses, Services, or Products if you are under 13 years old. If you’re younger than 13, you are not permitted to enter any Personal Information on this Site.

If you are a parent and you believe your child under the age of 13 has provided us with Personal Information, please contact us immediately to have it removed by emailing us at [email protected].

  1. Fair Information Practices:

In order to comply with Fair Information Practices we will take the following responsive action, should a data breach occur:

We will notify you via email within 10 business days of any known breach.

  1. CAN-SPAM Act of 2003:

The CAN-SPAM Act is a U.S. law which establishes rules for commercial email messages, gives you the right to stop certain commercial emails from being sent to you, and outlines certain penalties for commercial entities or persons who violate the law.

We collect your email address and name so we can:

  • Send information, respond to inquiries, and/or other requests or questions.
  • Process orders and to send information and updates pertaining to orders of a course, product, or service.
  • Send you additional information related to your course, product and/or service.
  • Market to our mailing list or continue to send emails to you after the original transaction has occurred.
  • Email you a newsletter with free information and advertising certain Products, Services, and/or Courses we offer.

In accordance with the CAN-SPAM Act, we agree to the following:

 

  • We WILL NOT use false or misleading subjects or email addresses.
  • We WILL NOT identify the email message as an advertisement in some reasonable way.
  • We WILL include our business mailing address and/or physical address in our emails.
  • We WILL monitor third-party email marketing services for compliance. We use ConvertKit to send our emails to you.
  • We WILLhonor opt-out/unsubscribe requests quickly.
  • We WILL allow users to unsubscribe by using the appropriate link at the bottom of each email.

TO UNSUBSCRIBE: 

If at any time you would like to unsubscribe from receiving future emails, you can email us at Madison at [email protected]  or follow the instructions at the bottom of any email you receive from us and we will promptly remove you from future correspondence(s). However, unsubscribing from one list or set of emails may not unsubscribe you from receiving ALL future emails from us. If you experience any problems unsubscribing, please email Madison at [email protected] and we will promptly handle your removal.

  1. Your General Data Protection Regulation (“GDPR”) Rights

If you are located within the European Union (“EU”), you are entitled to certain rights under the GDPR. You have the right to:

  • Know how long we’ll keep your information. We’ll keep your personal information until: (1) you either ask us to delete your information or (2) the Company decides it no longer needs the data and the cost of retaining it outweighs the value to keeping it.
  • Access, rectify or erase your personal information.
  • Withdraw your consent to the Company’s processing of your data, which shall have no effect on the lawfulness of the processing of your personal information prior to your withdrawal.
  • Lodge a complaint with a supervisory authority that has jurisdiction over GDPR issues.
  • Provide only your personal information which is reasonably required to enter into a contract with us. The Company will not ask for your consent to provide unnecessary personal information on the condition of entering into a contractual relationship with the Company.
  1. Contacting Us:

If there are any questions regarding this Privacy Policy, you may contact us using the following information:

Oak Physical Therapy & Wellness PC

Website: thevertigodoctor.com

Mailing Address: PO Box 1295 Wilson, WY 83014

Email: [email protected]

Updated on October 31, 2022

 

The Vertigo Doctor Privacy Policy

Your privacy is important to us

HIPAA Notice of Privacy Practices
With ARRA Amendments of 2009

Oak Physical Therapy & Wellness PC and Madison Oak

Notice of Privacy Practices

Effective Date: November 1, 2022 

 

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW THIS NOTICE CAREFULLY.

If you have any questions about this notice, please contact our privacy officer:

Madison Oak

PO Box 1295, Wilson, WY 83014

805-458-8751

  1. Summary of Rights and Obligations Concerning Health Information. Oak Physical Therapy & Wellness PC is committed to preserving the privacy and confidentiality of your health information, which is required both by federal and state law.  We are required by law to provide you with this notice of our legal duties, your rights, and our privacy practices, with respect to using and disclosing your health information that is created or retained by Oak Physical Therapy & Wellness PC.  Each time you visit us, we make a record of your visit. Typically, this record contains your symptoms, examination and test results, our assessment of your condition, a record of your treatment interventions, and a plan for future care or treatment. We have an ethical and legal obligation to protect the privacy of your health information, and we will only use or disclose this information in limited circumstances. In general, we may use and disclose your health information to:
  • plan your care and treatment;
  • provide treatment by us or others;
  • communicate with other providers such as referring physicians;
  • receive payment from you, your health plan, or your health insurer;
  • make quality assessments and work to improve the care we render and the outcomes we achieve, known as health care operations;
  • make you aware of services and treatments that may be of interest to you; and
  • comply with state and federal laws that require us to disclose your health information.

We may also use or disclose your health information where you have authorized us to do so.

Although your health record belongs to Oak Physical Therapy & Wellness PC, the information in your record belongs to you. You have the right to:

  • ensure the accuracy of your health record;
  • request confidential communications between you and your physician and request limits on the use and disclosure of your health information; and
  • request an accounting of certain uses and disclosures of health information we

have made about you.

We are required to:

  • maintain the privacy of your health information;
  • provide you with notice, such as this Notice of Privacy Practices, as to our legal duties and privacy practices with 

        respect to information we collect and maintain about you;

  • abide by the terms of our most current Notice of Privacy Practices;
  • notify you if we are unable to agree to a requested restriction; and
  • accommodate reasonable requests you may have to communicate health

information by alternative means or at alternative locations.

We reserve the right to change our practices and to make the new provisions effective for all your health information that we maintain.

Should our information practices change, a revised Notice of Privacy Practices will be available upon request. If there is a material change, a revised Notice of Privacy Practices will be distributed to the extent required by law.  We will not use or disclose your health information without your authorization, except as described in our most current Notice of Privacy Practices. In the following pages, we explain our privacy practices and your rights to your health information in more detail.

If you have limited proficiency in English, you may request a Notice of Privacy Practices in your requested language. 

  1. We may use or disclose your medical information in the following ways:

Treatment. We may use and disclose your protected health information to provide, coordinate and manage your rehab care.  That may include consulting with other health care providers about your health care or referring you to another health care provider for treatment including physicians, nurses, and other health care providers involved in your care.  For example, we may release your protected health information to a specialist to whom you have been referred to ensure that the specialist has the necessary information he or she needs to diagnose and/or treat you.  

Payment. We may use and disclose your health information so that we may bill and collect payment for the services that we provided to you. For example, we may contact your health insurer to verify your eligibility for benefits and may need to disclose to it some details of your medical condition or expected course of treatment. We may use or disclose your information so that a bill may be sent to you, your health insurer, or a family member. The information on or accompanying the bill may include information that identifies you and your diagnosis, as well as services rendered, any procedures performed, and supplies used. If, however, you pay cash at the time of service, we will not disclose your protected health information to your health plan or any other responsible payer unless you sign an authorization for us to do so.  If we agree to await payment from your health plan or put you on a payment plan, we may provide health information to a collection agency, small claims court or other court of competent jurisdiction in the event your claims for our services are not paid within 90 days and you have not made alternative payment arrangements with us.  

Health Care Operations.  We may use and disclose your health information to assist in the operation of our   

practice. For example, we may use information in your health record to assess the care and outcomes in your   case and others like it as part of a continuous effort to improve the quality and effectiveness of the healthcare and services we provide. We may use and disclose your health information to conduct cost-management and business planning activities for our practice. 

Business Associates. Madison Oak and/or Oak Physical Therapy & Wellness PC sometimes contracts with third-party business associates for services. Examples include answering services, transcriptionists, billing services, consultants, fitness instructors, contract physical therapists,  and legal counsel. We may disclose your health information to our business associates so that they can perform the job we have asked them to do. To protect your health information, however, we require our business associates to appropriately safeguard your information.

Appointment Reminders. We may use and disclose Information in your medical record to contact you as a reminder that you have an appointment.    PTEverywhere.com sends an automatic reminder email 2 days before your appointment to your provided email address. However, you may request that we email you only at a certain address or that we refrain from leaving emails and we will endeavor to accommodate all reasonable requests.

Treatment Options. We may use and disclose your health information in order to inform you of alternative treatments.  

Release to Family/Friends. Our staff, using their professional judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, your health information to the extent it is relevant to that person’s involvement in your care or for payment related to your care. We will provide you with an opportunity to object to such a disclosure whenever we practicably can do so. We may disclose the health information of minor children to their parents or guardians unless such disclosure is otherwise prohibited by law.  However, please note that state law may prohibit us from disclosing medical information to a parent or guardian at the child’s request if the child is of a certain age.  

Health-Related Benefits and Services.  We may use and disclose health information to tell you about health-related benefits or services that may be of interest to you. In face- to-face communications, such as appointments with your provider, we may tell you about other products and services that may be of interest you.

Newsletters and Other Communications. We may use your personal information in order to communicate to you via newsletters (including electronic newsletters – subject to applicable anti-spam laws), mailings, or other means regarding treatment options, health related information, disease management programs, wellness programs, or other community based initiatives or activities in which our practice is participating.

Disaster Relief. We may disclose your health information in disaster relief situations where disaster relief organizations seek your health information to coordinate your care or notify family and friends of your location and condition. We will provide you with an opportunity to agree or object to such a disclosure whenever we practicably can do so.

Marketing.  In most circumstances, we are required by law to receive your written authorization before we use or disclose your health information for marketing purposes. However, we may provide you with promotional gifts of nominal value and market services or products to you in face-to-face communications. Under no circumstances will we sell our patient lists or your health information to a third party without your written authorization.   

Public Health Activities. We may disclose medical information about you for public health activities. These activities generally include the following:

  • licensing and certification carried out by public health authorities;
  • prevention or control of disease, injury, or disability;
  • reports of births and deaths;
  • reports of child abuse or neglect;
  • notifications to people who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
  • organ or tissue donation; and
  • notifications to appropriate government authorities if we believe a patient has been the victim of abuse, neglect, or domestic violence. We will make this disclosure when required by law, or if you agree to the disclosure, or when authorized by law and in our professional judgment disclosure is required to prevent serious harm.

Food and Drug Administration (FDA). We may disclose to the FDA and other regulatory agencies of the federal and state government health information relating to adverse events with respect to food, supplements, products and product defects, or post-marketing monitoring information to enable product recalls, repairs, or replacement.

Research. We may disclose your health information to researchers when the information does not directly identify you as the source of the information or when a waiver has been issued by an institutional review board or a privacy board that has reviewed the research proposal and protocols for compliance with standards to ensure the privacy of your health information.

Workers Compensation. We may disclose your health information to the extent authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law. 

Law Enforcement. We may release your health information:

  • in response to a court order, subpoena, warrant, summons, or similar process of authorized under state or federal law;
  • to identify or locate a suspect, fugitive, material witness, or similar person; 
  • about the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement;
  • about a death we believe may be the result of criminal conduct;
  • about criminal conduct at [name of provider];
  • to coroners or medical examiners;
  • in emergency circumstances to report a crime, the location of the crime or victims, or the identity, description, or location of the person who committed the crime;
  • to authorized federal officials for intelligence, counterintelligence, and other national security authorized by law; and
  • to authorized federal officials so they may conduct special investigations or provide protection to the President, other authorized persons, or foreign heads of state.

De-identified Information. We may use your health information to create “de-identified” information or we may disclose your information to a business associate so that the business associate can create de-identified information on our behalf. When we “de-identify” health information, we remove information that identifies you as the source of the information. Health information is considered “de-identified” only if there is no reasonable basis to believe that the health information could be used to identify you.

Personal Representative. If you have a personal representative, such as a legal guardian, we will treat that person as if that person is you with respect to disclosures of your health information. If you become deceased, we may disclose health information to an executor or administrator of your estate to the extent that person is acting as your personal representative.

HLTV-III Test.  We will not disclose the fact that you have taken the test to anyone without your written consent unless otherwise required by law.  

Limited Data Set. We may use and disclose a limited data set that does not contain specific readily identifiable information about you for research, public health, and health care operations. We may not disseminate the limited data set unless we enter into a data use agreement with the recipient in which the recipient agrees to limit the use of that data set to the purposes for which it was provided, ensure the security of the data, and not identify the information or use it to contact any individual.

  1. Authorization for Other Uses of Medical Information. Uses of medical information not covered by our most current Notice of Privacy Practices or the laws that apply to us will be made only with your written authorization. You should be aware that we are not responsible for any further disclosures made by the party you authorize us to release information to.  If you provide us with authorization to use or disclose medical information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization, except to the extent that we have already taken action in reliance on your authorization or, if the authorization was obtained as a condition of obtaining insurance coverage and the insurer has the right to contest a claim or the insurance coverage itself. We are unable to take back any disclosures we have already made with your authorization, and we are required to retain our records of the care that we provided to you.
  1. Your Health Information Rights.  You have the following rights regarding medical information we gather about you:
A. Right to Obtain a Paper Copy of This Notice. You have the right to a paper copy of this Notice of Privacy Practices at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy.
B. Right to Inspect and Copy.

 

To inspect and copy medical information, you must submit a written request to our privacy officer. We will supply you with a form for such a request. If you request a copy of your medical information, we may charge a reasonable fee for the costs of labor, postage, and supplies associated with your request. We may not charge you a fee if you require your medical information for a claim for benefits under the Social Security Act (such as claims for Social Security, Supplemental Security Income, and any other state or federal needs-based benefit program.

If your medical information is maintained in an electronic health record, you also have the right to request that an electronic copy of your record be sent to you or to another individual or entity. We may charge you a reasonable cost-based fee limited to the labor costs associated with transmitting the electronic health record.

C. Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as we retain the information.  

To request an amendment, your request must be made in writing and submitted to our privacy officer. In addition, you must provide a reason that supports your request.  We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

  • was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
  • is not part of the medical information kept by or for [name of provider];
  • is not part of the information which you would be permitted to inspect and copy; or
  • is accurate and complete.

If we deny your request for amendment, you may submit a statement of disagreement.  We may reasonably limit the length of this statement. Your letter of disagreement will be included in your medical record, but we may also include a rebuttal statement.

D. Right to an Accounting of Disclosures. You have the right to request an accounting of disclosures of your health information made by us. In your accounting, we are not required to list certain disclosures, including:

  • disclosures made for treatment, payment, and health care operations purposes or disclosures made incidental 
  • to treatment, payment, and health care operations, however, if the disclosures were made through an electronic 
  • health record, you have the right to request an accounting for such disclosures that were made during the previous 3 years;
  • disclosures made pursuant to your authorization;
  • disclosures made to create a limited data set;
  • disclosures made directly to you.

To request an accounting of disclosures, you must submit your request in writing to our privacy officer. Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you would like the accounting of disclosures (for example, on paper or electronically by e-mail). The first accounting of disclosures you request within any 12-month period will be free. For additional requests within the same period, we may charge you for the reasonable costs of providing the accounting of disclosures. We will notify you of the costs involved and you may choose to withdraw or modify your request at that time before any costs are incurred. Under limited circumstances mandated by federal and state law, we may temporarily deny your request for an accounting of disclosures.

E. Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations. If you paid out-of-pocket for a specific item or service, you have the right to request that medical information with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and we are required to honor that request.  You also have the right to request a limit on the medical information we communicate about you to someone who is involved in your care or the payment for your care.

Except as noted above, we are not required to agree to your request. If we do agree, we will comply with your request unless the restricted information is needed to provide you with emergency treatment.  To request restrictions, you must make your request in writing to our privacy officer. In your request, you must tell us:

  • what information you want to limit;
  • whether you want to limit our use, disclosure, or both; and
  • to whom you want the limits to apply.

F. Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by e-mail.  To request confidential communications, you must make your request in writing to your provider or our privacy officer. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

G. Right to Receive Notice of a Breach. We are required to notify you by first class mail or by e-mail (if you have indicated a preference to receive information by e-mail), of any breaches of Unsecured Protected Health Information as soon as possible, but in any event, no later than 60 days following the discovery of the breach. “Unsecured Protected Health Information” is information that is not secured through the use of a technology or methodology identified by the Secretary of the U.S. Department of Health and Human Services to render the Protected Health Information unusable, unreadable, and undecipherable to unauthorized users. The notice is required to include the following information:

  • a brief description of the breach, including the date of the breach and the date of its discovery, if known;
  • a description of the type of Unsecured Protected Health Information involved in the breach;
  • steps you should take to protect yourself from potential harm resulting from the breach;
  • a brief description of actions we are taking to investigate the breach, mitigate losses, and protect against further breaches;
  • contact information, including a toll-free telephone number, e-mail address, Web site or postal address to permit you to ask questions or obtain additional information.  In the event the breach involves 10 or more patients whose contact information is out of date we will post a notice of the breach on the home page of our Web site or in a major print or broadcast media. If the breach involves more than 500 patients in the state or jurisdiction, we will send notices to prominent media outlets. If the breach involves more than 500 patients, we are required to immediately notify the Secretary. We also are required to submit an annual report to the Secretary of a breach that involved less than 500 patients during the year and will maintain a written log of breaches involving less than 500 patients.
  1. Complaints.  If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services, 200 Independence Ave, S.W., Washington, D.C. 20201. To file a complaint with us, contact our privacy officer at the address listed above. All complaints must be submitted in writing and should be submitted within 180 days of when you knew or should have known that the alleged violation occurred. See the Office for Civil Rights website, www.hhs.gov/ocr/hipaa/ for more information.  You will not be penalized for filing a complaint.

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