- To business associates we have contracted with to perform the agreed upon service, in most cases, this information will only consist of your name, patient ID and when your recommendation expires;
- To remind you that you have an appointment;
- To assess your satisfaction with our services;
- To tell you about possible treatment alternatives;
- To tell you about health related benefits or services;
- To contact you as part of fund raising efforts;
- For population based activities relating to improving health or reducing health care costs;
- Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial by reviewed. Another licensed health care professional chosen by THC will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
- 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 the information is kept by or for THC. We may deny your request for an amendment and if this occurs, you will be notified of the reason for denial.
- An Accounting of Disclosure: You have the right to request an accounting of disclosures. This is a list of certain disclosures we make of your medical information for purposes other than treatment or health care operations.
- 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. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
- 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 may ask that we contact you at work or by U.S. Mail. THC will grant requests for confidential communications at alternative locations and/or via alternative means only if the request is submitted in writing and the written request includes a mailing address. We reserve the right to contact you by other means and at other locations if you fail to respond to any communication from us that requires a response. We will notify you in accordance with your original request prior to attempting to contact you by other means or at another location.
- A Paper Copy of This Notice: You have the right to a paper copy of this Notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to paper copy of this notice. You may also obtain a copy of this Notice at our website.
THC NOTICE OF PRIVACY PRACTICES
Effective Date: 2/27/2008
This Notice describes how medical information about you may be used and disclosed and how you can get access to this information. PLEASE REVIEW IT CAREFULLY.
Each time you visit Hemp Medicine Evaluation Centers (THC), a record of your visit is made. Typically, this record contains your symptoms, examination, and test results, diagnoses, treatment, a plan for future care or treatment, and billing-related information. This Notice applies to all of the records of your care generated by THC, whether made by THC personnel or agents of the THC.
Our Responsibilities
We will abide by the terms of this Notice with regard to maintaining the privacy of your health information and provide you a description of our privacy practices. We may change the terms of our Notice at any time, which will be effective for all information that we maintain at that time. To obtain a copy of any revised Notice, you may visit our website, call the number listed at the end of this Notice and request a copy, or ask for a copy at the time of your next visit.
How we may use and disclose medical information about you:
The following categories describe examples of the way we use and disclose medical information:
For Treatment: We may use and disclose medical information about you to provide you treatment or services. For example, the doctors, nurses, or other THC personnel who are involved in taking care of you at THC will all have access to your information.
For Health Care Operations: Members of THC staff may use information in your health record for health care operations. For example, to assess the care and outcomes in your case and others like it, to continually improve the quality of care for all patients we serve, and for internal education purposes.
We may also use and disclose medical information:
Business Associates: There are some services provided at THC through contracts with business associates, such as management services for THC. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we’ve asked them to do. To protect your health information, however, we require the business associate to appropriately safeguard your information.
Individuals Involved in Your Care: We may release medical information about you to a friend or family member who is involved in your medical care.
Research: We may disclose information to researchers when an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved their research.
Future Communications: We may communicate to you via newsletters, mailings, or other means regarding treatment options, health related information, disease-management programs, wellness programs, or other community based initiatives or activities THC is participating in.
As Required by Law: We may also use and disclose health information upon court order.
Law Enforcement/Legal Proceedings: We may disclose health information for law enforcement purposes as required by court order or in response to a valid subpoena.
State-Specific Requirements: Some states have separate privacy laws that may apply additional legal requirements. If the State privacy laws are more stringent than Federal privacy laws, the State law preempts the Federal law.
Your Health Information Rights
Although your health record is the physical property of the practitioner that compiled it, you have the right to:
To exercise any of your right, please obtain the required forms from the Privacy Official and submit your request in writing.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a written complaint with THC by contacting the THC Privacy Official as listed below. You will not be penalized for filing a complaint.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
FACILITY PRIVACY OFFICIAL
If you have any questions about this notice, please contact THC’s Private Official at 408.262.3412.