Notice of Privacy Practices

When it comes to your health information, you have certain rights.

Get a copy of your medical record. Ask to see or get an electronic or paper copy of your records. We will provide it, usually within 30 days, and may charge a reasonable, cost-based fee.

Ask us to correct your record. Ask us to correct information you think is incorrect or incomplete. We may say no, but we will tell you why in writing within 60 days.

Request confidential communications. Ask us to contact you in a specific way (for example, a mobile phone) or to send mail to a different address. We will say yes to all reasonable requests.

Ask us to limit what we use or share. You can ask us not to use or share certain information. We are not required to agree, but if you pay for a service in full out of pocket, you can ask us not to share it with your health insurer, and we will agree unless the law requires us to share it.

Get a list of those we have shared information with. Ask for a list of the times we have shared your information in the six years before your request, who we shared it with, and why. This excludes disclosures for treatment, payment, health care operations, and certain others. One list a year is free.

Get a copy of this notice. Ask for a paper copy at any time, even if you agreed to receive it electronically.

Choose someone to act for you. If someone is your health care power of attorney or legal guardian, they can exercise your rights. We will confirm their authority first.

File a complaint. If you feel your rights have been violated, contact our Privacy Officer at (480) 788-1363 or kd@atypicalhealthcare.com, or the U.S. Department of Health and Human Services Office for Civil Rights: 200 Independence Avenue SW, Washington, D.C. 20201; 1-877-696-6775; www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

Tell us your preference, and we will follow your instructions, for:

• Sharing information with family, close friends, or others involved in your care
• Sharing information in a disaster relief situation

If you cannot tell us your preference — for example, if you are unconscious — we may share your information if we believe it is in your best interest, and when needed to lessen a serious and imminent threat to health or safety.

We never share your information for these purposes unless you give us written permission: marketing; sale of your information; use of your photographs or testimonials in advertising or social media.

To treat you. Example: our nurse uses the medical history your provider recorded to give your treatment safely.

To run our practice. Example: we use your information to manage your care, review the quality of our services, train staff, and send appointment reminders.

To bill for your services. Example: we use your information to process payment for your treatment.

We may also use or share your information, as allowed or required by law, to:

• Help with public health and safety issues, such as reporting adverse reactions to medications, preventing disease, reporting suspected abuse or neglect, and preventing a serious threat to anyone's health or safety
• Comply with the law, including when the Department of Health and Human Services asks to check our compliance
• Respond to organ and tissue donation requests and work with a medical examiner or funeral director
• Address workers' compensation claims, law enforcement purposes, health oversight agencies, and special government functions such as military and national security
• Respond to lawsuits and legal actions, such as a court order or subpoena
• Do research, under conditions set by law

Some state laws give more protection to certain information, such as HIV and communicable disease information and genetic test results. We follow those laws where they apply.

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us in writing that we can. If you do, you may change your mind at any time by telling us in writing.

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available on request, in our office, and on our website.