This notice describes how medical information about patients seen in Health Services may be used and disclosed, and how this information can be accessed. This information should be read carefully.
If there are any questions about this Notice, they should be directed toward the Health Services at (217) 206-6676, or firstname.lastname@example.org
This notice of Privacy Practices and Acknowledgement of Receipt of Privacy Notice describes how we may use and disclose protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes patient rights to access and control their protected health information. Protected health information is information about you seen, including demographic information that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services. We may change the terms of our notice at any time. The new notice will be effective for all protected health information that we maintain at the time. You may request any revised Notice of Privacy Practices by accessing our website, calling Health Services and requesting that a revised copy be sent to them by mail or asking for one at the HS reception desk.
Uses and Disclosures of Protected Health Information Based Upon Your Written Authorization:
Other uses and disclosure of protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below. Your may revoke this authorization at any time, in writing, except to the extent that Health Services has taken an action in reliance on the use or disclosure indicated in that authorization.
Other Permitted and Required Uses and Disclosures That May Be Made Without an Individuals Consent, Authorization or Opportunity to Object.
We may use or disclose an individuals protected health information in the following situations without their consent or authorization. These situations include:
- Required By Law
- Public Health
- Communicable Disease
- Health Oversight
- Abuse or Neglect
- Food and Drug Administration
- Legal Proceedings
- Law Enforcement and criminal Activity
- Coroners, Funeral Directors, and Organ Donation
- Military Activity and National Security
- Workers Compensation
- Individual’s Rights
Complaints: Should you have questions, or if you believe your privacy rights have been violated, you can file a complaint by contacting Health Services (217) 206-6676. There will be no retaliation for filing a complaint.