Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please read it carefully.
Our Obligation to You
We at The Bradley Clinic respect your privacy. This is part of our code of ethics. We are required by law to maintain the privacy of “Protected Health Information” (“PHI”) about you, to notify you of our legal duties and your legal rights, and to follow the privacy policies described in this notice.
“Protected health information” means any information, whether written, electronic, or oral, including demographic information, that relates to:
- Your past, present or future physical or mental health or condition;
- The provision of health care to you;
- The past, present or future payment for the provision of health care services to you;
- And that identifies you or can reasonably be used to identify you.
Use and Disclosure of Information about You
The Bradley Clinic may use and disclose your PHI, without your authorization, for purposes of treatment, payment and health care operations.
- Staff involved in your care may access your clinical records.
- Blood samples may be sent to labs for analysis.
- We may coordinate with your health plan or other providers.
- We may contact you for appointments, treatment options, or services.
- We may disclose PHI to arrange payment for services rendered.
Other Uses and Disclosures That Do Not Require Your Authorization:
- Emergencies: To avert serious health or safety issues.
- Family and Friends: With your permission or if you do not object.
- Legal Requirements: Court orders, laws, regulations.
- Research: When approved by appropriate boards.
- Government Functions: Military, national security, correctional institutions, etc.
- Workers Compensation: To comply with related laws.
Uses or Disclosures That Do Require Your Authorization:
- Psychotherapy notes (except for allowable uses).
- Marketing or sale of your PHI.
Your Legal Rights
- Confidential Communications: You may request discreet communication methods.
- Restriction Requests: You may request limits on how your PHI is used/disclosed.
- Revoke Authorization: You may revoke prior consent, effective going forward.
- Access Records: You can inspect or obtain a copy of your records.
- Amend Records: You can request a correction to your records.
- Paper Copy: You may request a printed copy of this notice.
- Communication Preferences: You can request specific ways to communicate.
- Breach Notification: You will be notified in the event of a breach.
Acknowledgement of Receipt
I have received a copy of the Notice of Privacy Practices for The Bradley Clinic.
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