Your Information. Your Rights. Our Responsibilities.
This notice describes how medical information about you may be used and disclosed and how you can obtain access to this information
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Your Rights
You have the right to:
- Receive a copy of your paper or electronic medical record
- Correct your paper or electronic medical record
- Request confidential communication
- Ask us to limit the information we share
- Get a copy of this privacy notice
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- Receive a list of those with whom we have shared your information
- Choose someone to act for you
- File a complaint if you believe your privacy rights have been violated
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Your Choices
You have some choices in the way that we use and share information as to how we:
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- Tell family and friends about your condition
- Provide disaster relief
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- Provide mental health and addiction care
- Raise funds
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Our Uses and Disclosures
We may use and share your information as we:
- Treat you
- Run our organization
- Comply with program audits
- Help with program audits
- Help with public health and safety issues
- Do research
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- Comply with the law
- Address worker’s compensation, law enforcement and other government requests
- Respond to lawsuits and legal actions
- Immigration enforcement by subpoena only
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Our Responsibilities
- 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 we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind
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For more Information:
We may change the Terms of this Notice and the changes will apply to all the information we have about you. The new notice will be available upon request, in our office and on our website
Revised 05/15/25
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