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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. 

Personally identifiable information about your health, your health care, and your payment for health care is called Protected Health Information.  We must safeguard your Protected Health Information and give you this Notice about our privacy practices that explains how, when and why we may use or disclose your Protected Health Information.  Except in the situations set out in the Notice, we must use or disclose only the minimum necessary Protected Health Information to carry out the use or disclosure.  We must follow the practices described in this Notice, but we can change our privacy practices and the terms of this Notice at any time. If we revise the Notice, you will receive the new version of the Notice of Privacy Practices.  You also may ask for a copy of the Notice by calling us at (860)809-5811 and asking us to mail you a copy or by asking for a copy at your next appointment. 

Uses and Disclosures of Your Protected Health Information That Do Not Require Your Consent We may use and disclose your Protected Health Information as follows without your permission: For treatment purposes.  We may disclose your health information to doctors, nurses and others who provide your health care.  For example, your information may be shared with people performing lab work or x-rays. To obtain payment.  We may disclose your health information in order to collect payment for your health care.  For instance, we may release information to your insurance company. Appointment reminders. Our practice may use and disclose your PHI to contact you and remind you of an appointment. For health care operations.  We may use or disclose your health information in order to perform business functions like employee evaluations and improving the service we provide.   

When required by law.  We may be required to disclose your Protected Health Information to law enforcement officers, courts or government agencies.  For example, we may have to report abuse, neglect or certain physical injuries. For public health activities.  We may be required to report your health information to government agencies to prevent or control disease or injury.  For health oversight activities.  We may be required to disclose your health information to government agencies so that they can monitor or license health care providers such as doctors and nurses. To avert a threat to health or safety.  In order to avoid a serious threat to health or safety, we may disclose health information to law enforcement officers or other persons who might prevent or lessen that threat. For fundraising purposes. We may use certain information (such as demographic information, dates of services, department of service, treating physicians, and outcomes) to send fundraising communications to you. However, you may opt out of receiving any such communications by contacting our Privacy Officer (listed below) and your decision to opt-out will have no impact on your treatment. 

Uses and Disclosures of Your Protected Health Information that offer you an opportunity to object In the following situations, we may disclose some of your Protected Health Information if we first inform you about the disclosure and you do not object:  To your family, friends or others involved in your care.  We may share with these people information related to their involvement in your care or information to notify them as to your location or general condition.  

Uses and Disclosures of Your Protected Health Information That Require Your Consent The following uses and disclosures of your Protected Health Information will be made only with your written permission, which you may withdraw at any time: For research purposes.  In order to serve our patient community, we may want to use your health information in research studies.  Without your permission, we will not send you mail or call you on the telephone in order to urge you to use a particular product or service, unless such a mailing or call is part of your treatment.  Additionally, without your permission we will not sell or otherwise disclose your Protected Health Information to any person or company seeking to market its products or services to you. 

Confidential communications. You have the right to request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. In order to request a type of confidential communication, you must make a written request to Allison Zipser (860)809-5811 specifying the requested method of contact, or the location where you wish to be contacted. Our practice will accommodate reasonable requests. You do not need to give a reason for your request. For any other purposes not described in this Notice.  Without your permission, we will not use or disclose your health information under any circumstances that are not described in this Notice. 
Your Rights Regarding Your Protected Health Information You have the following rights related to your Protected Health Information: To inspect and request a copy of your Protected Health Information.  You may look at and obtain a copy of your Protected Health Information .   To request that we correct your Protected Health Information.  If you think that there is a mistake or a gap in our file of your health information, you may ask us in writing to correct the file.  We may deny your request if we find that the file is correct and complete, not created by us, or not allowed to be disclosed.  If we deny your request, we will explain our reasons for the denial and your rights to have the request and denial and your written response added to your file.  If we approve your request, we will change the file, report that change to you, and tell others that need to know about the change in your file. To request a restriction on the use or disclosure of your Protected Health Information.  An exception is that we must agree to a request not to send Protected Health Information to a health plan for purposes of payment or health care operations if you have paid in full for the related product or service.  

We cannot limit uses or disclosures that are required by law. To request confidential communication methods.  You may ask that we contact you at a certain address or in a certain way.  We must agree to your request as long as it is reasonably easy for us to do so.  To find out what disclosures have been made.  You may get a list describing when, to whom, why, and what of your Protected Health Information has been disclosed during the past six years.  We must respond to your request within sixty days of receiving it.  The list will not include disclosures made to you or for purposes of treatment, payment, health care operations if we do not use electronic health records, our patient directory, national security, law enforcement, and certain health oversight activities. To receive notice if your records have been breached.  We will notify you if there has been an acquisition, access, use or disclosure of your Protected Health Information in a manner not allowed under the law and which we are required by law to report to you.,   We will review any suspected breach to determine the appropriate response under the circumstances. 

To obtain a paper copy of this Notice.  Upon your request, we will give you a paper copy of this Notice.  If you have any questions about these rights, please contact us. How to Complain about Our Privacy Practices If you think we may have violated your privacy rights, or if you disagree with a decision we made about your Protected Health Information, you may file a complaint with Allison Zipser. We will take no action against you if you make a complaint to either or both of these persons. How to Receive More Information About our Privacy Practices If you have questions about this Notice please contact Allison Zipser.