This notice describes how information about you may be used and disclosed and how you can get access to this information.
Each time you have an appointment with Stacy Darby LAc, a record of your visit is made. Generally, this includes a health history, a review of your symptoms, diagnostic testing, acupuncture treatment and plan for further care. This information is referred to as your medical record and serves as:
• the basis for planning your care, treatment and follow-up.
• an education tool for reviewing, assessing and improving the care rendered at the clinic.
• a means of communication among health care professionals who contribute to your care.
• a legal document describing the care you have received.
• a potential resource for medical research data.
• a tool for educating health professionals.
• a source of information for public health officials charged with improving the health of the nation.
Understanding what is in your health record and how this information is used will assist you in:
• ensuring its accuracy.
• better understanding who, what, when, where and why others may access your health information.
• making informed decisions when authorizing disclosures to others.
Your health record is the physical property of this office. However, the information contained in it belongs to you. You have the right to:
• request a restriction on certain uses or disclosures of your information.
• obtain a paper copy of this notice of information practices upon request.
• inspect and have a copy of your medical record.
• amend and/or have a “statement of disagreement” placed in your medical record.
• obtain an accounting of disclosures of your health information outside the scope of normal clinic operations. If an individual requests a copy of the PHI or agrees to a summary of care, Stacy Darby LAc, may impose a reasonable, cost-based fee. (Fees set by the Department of Human and Health Services)
• request communications of your health information by alternative means or at Alternative sites.
• revoke your authorization to use or disclose health information except to the extent that action has already been taken.
This office is required by law to:
• maintain the privacy of your health information.
• provide you with a notice as to our legal duties and privacy practices with respect to the information we collect and maintain about you.
• abide by the terms contained within this notice.
• notify you if we are unable to accept your request for limiting or restricting certain uses and disclosures.
• accommodate reasonable requests you may have for communication of your health information through alternative means and/or alternative locations.
We reserve the right to change or modify our practices and to make new provisions effective for all protected health information (PHI) we maintain. Should our practices change, a reasonable attempt will be made to notify you. We will not use or disclose your PHI without your authorization, except as described in this notice.
If you need any further assistance, please contact Stacy Darby at (503)753-2611, or by email at stacy@lightessence.org. If you believe your privacy rights have been violated, you can file a complaint with the above or with the local Department of Health and Social Services. There will be no retaliation or penalty for filing a complaint.
These disclosures and uses do not require your authorization, but are required to facilitate your care, and/or required by other State and Federal laws.
Treatment: Health information obtained by the acupuncturist is recorded in your medical record and is used to determine what type of health treatment should be provided.
Communication with Family Members: With your written consent, we may disclose to a family member, other relative, close personal friend, or any other person you identify, health care information relevant to that person’s involvement in your care.
Marketing: We may contact you to remind you of your appointment.
Public Health: As required by law, we may disclose your PHI to public health officials or legal authorities to prevent or control disease, injury or disability, to notify a person who may be at risk for contracting or spreading a disease or condition, or to notify the appropriate government authority if we believe a patient has been a victim of abuse, neglect or domestic violence.
As Required by Law: We will disclose medical information about you when required to do so by federal, state, or local law.
National Security, Law Enforcement, Child/Elder Abuse, Military/Veterans, Lawsuits/Disputes, and Health Oversight: These disclosures may occur as mandated by law or in response to valid legal processes as outlined in our full policy.
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