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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. If you have any questions
about this notice, please contact : Essam Michael at 905
949 6999.
.
This notice describes the privacy practices at our office.
We are required
by law to:
* Maintain the privacy of protected
health information
* Give you this notice of our legal duties and privacy
practices
regarding your health information
* Follow the terms of the notice currently in effect.
How we may
use and disclose your health information
Described as follows are the ways
we may use and disclose your health information. Except
for the following purposes we will use and disclose your
health information only with your written permission.
You may revoke such permission at any time by writing
to Essam Michael.
Treatment. We
may use and disclose your health information for your
treatment and to provide you with treatment-related health
care services. For example, we may disclose your health
information to doctors, nurses, technicians, or other
personnel, including people outside our office, who are
involved in your medical care and need the information
to provide you with medical care.
Payment. We may
use and disclose your health information so that others
or we may bill and receive payment from you, an insurance
company, or a third party for the treatment and services
you received. For example, we may give information to
your health plan so that they will pay for your
treatment.
Health Care Operations.
We may use and disclose your health information to evaluate
and improve our medical care and to operate and manage
our office. For example, we may use and disclose information
to a peer review organization or a health plan that is
evaluating our care. We may also share information with
others that have a relationship with you for their health
care operation activities.
Appointment Reminders,
Treatment Alternatives, and Health-Related Benefits and
Services. We may use and disclose your health
information to contact you and remind you of your appointment,
to tell you about treatment alternatives or health-related
benefits and services you could use.
Individuals Involved in
Your Care or Payment for Your Care. When appropriate,
we may share your health information with a person involved
in, or paying or, your care (such as your family or a
close friend). We may notify your family about your location
or condition or disclose such information to an entity
assisting in disaster relief.
Research. We may
use and disclose your health information for research.
For example, a research project may involve comparing
the health of patients who received one treatment to those
who received another for the same condition. Before we
do so, the project needs to go through a special approval
process. Even without special approval, we may permit
researchers to look at records to help identify patients
who may be included in their research, as long as they
do not remove or copy any of your health information.
As Required by Law.
We will disclose your health information when required
to do so by international, federal, state or local law.
To Avert a Serious Threat
to Health or Safety. We may use and disclose
your health information when necessary to prevent a serious
threat to the health and safety of you, another person,
or the public. Disclosures will be made only to someone
who can prevent the threat.
Business Associates.
We may disclose your health information to our business
associates that perform functions on our behalf or provide
us with services if necessary. For example, we may use
another company to perform billing services on our behalf.
All of our business associates are obligated to protect
the privacy of your information and are not allowed to
use or disclose the information for any other purpose
than appears in their contract with us.
Military and Veterans.
If you are a member of the armed forces, we may release
your health information as required by military command
authorities. If you are a member of a foreign military
we may release your health information to the foreign
military command authority.
Worker's Compensation.
We may release your health information for worker's compensation
or similar programs that provide benefits for work-related
injuries or illness.
Public Health Risks.
We may disclose your health information for public health
activities to prevent or control disease, injury or disability.
We may use your health information in reporting births
or deaths, suspected child abuse or neglect, medication
reactions or product malfunctions or injuries, and product
recall notifications. We may use your health information
to notify someone who may have been exposed to a disease
or may be at risk for contracting or spreading a disease
or condition. If we are concerned that a patient may have
been a victim of abuse, neglect, or domestic violence
we may ask your permission to make a disclosure to an
appropriate government authority. We will make that disclosure
only when you agree or when required or authorized to
do so by law.
Health Oversight Activities.
We may disclose your health information to a health oversight
agency for activities authorized by law. These may include
audits, investigations, inspections, and licensure. These
activities are necessary to for the government to monitor
the health care system, government programs, and compliance
with civil rights laws.
Lawsuits and Disputes.
If you are involved in a lawsuit or dispute, we may disclose
your health information in response to a court or administrative
order. We may disclose your health information in response
to a subpoena, discovery request, or other lawful process
by someone else involved in the dispute, but only if efforts
have been made to tell you about the request or to obtain
an order protecting the information requested.
Law Enforcement.
We may release your health information request by law
enforcement official if 1) there is a court order, subpoena,
warrant, summons or similar process; 2) if the request
is limited to information needed to identify or locate
a suspect, fugitive, material witness, or missing person;
3) the information is about the victim of a crime even
if, under certain very limited circumstances, we are unable
to obtain your agreement; 4) the information is about
a death that may be the result of criminal conduct; 5)
the information is relevant to criminal conduct on our
premises; and 6) it is needed in an emergency to report
a crime, the location of a crime or victims, or the identity,
description, or location of the person who may have committed
the crime.
Coroners, Medical Examiners, and Funeral Directors. We
may release your health information to a coroner, medical
examiner, or funeral director to identify a deceased person
or cause of death, or other similar circumstance.
National Security and Intelligence
Activities. We may disclose your health information
to authorized federal officials for intelligence and other
national security activities authorized by law.
Inmates or Individuals
in Custody. If you are an inmate of a correctional
institution or in custody we may disclose your information
1) for the institution to provide you with health care,
2) to protect your health and safety or that of others,
and 3) for the safety and security of the institution.
YOUR RIGHTS
REGARDING YOUR HEALTH INFORMATION
Right to Inspect and Copy.
You have the right to inspect and copy your medical and
billing records by written request to Essam Michael.
Right to Amend.
You have the right to request an amendment to your records
by written request to Essam Michael.
Right to an Accounting
Of Disclosures. You have a right to an accounting
of certain disclosures by written request to Essam Michael.
Right to Request Restrictions.
You have the right to request restriction or limitation
on your health information used for treatment, payment
or health are operations. You may request us to limit
disclosure to someone involved in your care or in payment
for your care (such as a spouse) by written request to
Essam Michael. We are not required to agree with your
request, but we will try to comply.
Right to Request Confidential
Communication. You have the right to request
that we communicate with you about medical matters in
a certain way or at a certain location. You can ask, for
example, that we contact you only by mail or at work.
Your written request must specify how or where you wish
to be contacted and be addressed to Essam Michael. We
will accommodate reasonable requests.
CHANGES TO THIS NOTICE
We may change this notice and make
it effective for medical information we already have about
you as well as new information. The current notice will
be posted and available at all times. You have a right
to request a paper copy of the current notice at any visit
or by written request to Essam Michael. |