This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
If you have any questions about this notice, please contact The Care Center's Privacy Officer at (203) 637-3599.
Who will follow this notice: The Care Center and its staff who have access to patients' information will follow privacy practices in accordance with Health Insurance Portability Accountability Act (HIPAA) standards.
Your health information: This notice applies to the information and records we have about your health, health status, and the healthcare and services you receive at this office.
How we may use and disclose health information about you: We may request your written, signed consent to use and disclose health information for the following purpose: For treatment, payment, healthcare operations, appointment reminders, treatment alternatives, health-related products and services.
Special situations: We may use or disclose health information about you without your permission for the following purposes, subject to all applicable legal requirements and limitations: To avert a serious threat to health and safety, or as required by law, for research, for organ and tissue donations, for military and veterans, national security and intelligence, for workers' compensation, for public health risks, for health oversights, for activities, for lawsuits and disputes, for law enforcement, for coroners, medical examiners and funeral directors, for information not personally identifiable, and for family and friends.
Other uses and disclosures of health information: In any other situation not covered by this notice, we will ask for your written authorization before using or disclosing medical information about you. If you choose to authorize use or disclosure, you can later revoke that authorization by notifying us in writing of your decision.
If we have HIV or substance abuse information about you, we cannot release that information without a special signed, written authorization (different from the Authorization and Consent mentioned above) from you. In order to disclose these types of records for purposes of treatment, payment or healthcare operations, we will need both your signed consent and a special written authorization that complies with the law governing HIV or substance abuse records.
Your rights regarding health information about you: You have the following rights regarding health information we maintain about you:
Right to inspect a copy of your records: You have the right to look at or get a copy of medical information that we use to make decisions about your care, when you submit a written request. If you request copies, we may charge a fee for the cost of copy, mailing, or other related supplies. If we deny your request to review or obtain a copy, you may submit a written request for a review of that decision. If you believe that information in your records is incorrect or that information is missing, you have the right to request that we correct your record, by submitting a request in writing that provides your reason for requesting the amendment. We can deny your request to amend a record if the information is not maintained by us, or if we determine that your record is accurate. You may submit a written statement of disagreement with a decision by us not to amend a record.
Right to an accounting of disclosures: You have the right to request a list accounting for any disclosures of your health information we made, except for uses and disclosure for treatment, payment, and healthcare operations, circumstances in which you have specially authorized such disclosures and certain other expectations. To request this list of disclosures, indicate that relevant period which must be after April 14, 2003, but in no event for the more than the last six (6) years. You must submit your request in writing.
Right to request restrictions: You may request, in writing, that we not use or disclose medical information about you for treatment, payment, or healthcare operations or to persons involved in your care except when specifically authorized by you, when required by law, or in an emergency. We will consider your request and work to accommodate it when possible, but we are not legally required to accept it. We will inform you of our decisions on your request.
Rights to confidential communications: You have the right to request that medical information about you be communicated to you in a confidential manner, such as sending mail to an address other than your home, by notifying us in writing of the specific way or location for us to use to communicate with you.
Right to request a paper copy of this notice: You may request a paper copy of this notice from us upon request, even if you have agreed to receive this notice electronically.
Changes to this notice: We have the right to change this notice, and to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a summary of the current notice in the office with its effective date in the top right hand corner. You are entitled to a copy of the notice currently in effect.
Complaints: If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. To file a complaint with our office, please contact the Privacy Officer at the number above. You will not be penalized for filing a complaint.
Sales Tax: We are required to collect sales tax on all shipments to Connecticut addresses only.
