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Drs. Dean & Hamilton
2724 Capital Circle NE Suite 1
(850) 385-4444 e-mail: Richard.Hamilton@thefocalpointe.com
Effective Date of Notice: April 11, 2011
NOTICE OF PRIVACY PRACTICES
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.
GENERAL RULE
We respect our legal obligation to keep health information that identifies you private. We are obligated by law to give you notice of our privacy practices.
Generally, we cannot use your health information in our office or disclose it outside of our office without your written permission. Sometimes the written permission will be called a consent form, and sometimes it will be called an authorization form. The type of some limited situation, the law allows or requires us to disclose your health information without either a written consent or authorization.
USES OR DISCLOSURES
We will ask you to sign a consent form allowing us to use and disclose your health information for purposes of treatment, payment, and health care operations of this office. We are allowed to refuse to treat you if you do not sign the consent form.
We will ask you to sign a consent form allowing us to use and disclose your health information for purposes of treatment, payment, and health care operations of this office. We are allowed to refuse to treat you if you do not sign the consent form.
The health record is the legal and physical property of The Focal Pointe but the information belongs to you. You may have access to inspect, amend, or obtain a copy of your health information. Costs will incur for copies of your records and are due in advance. An appointment must be made with the privacy officer to inspect, access, or amend your health information. The privacy officer for The Focal Pointe is Dr. Richard D. Hamilton.
The Focal Pointe will require my authorization to release my heath information to outside sources with the exception of disclosures for purposes of Treatment, Payment, and Healthcare Operations. These may include: access to your health information by The Focal Pointe physicians and staff as well as billing to you or a third-party payer.
In addition, Business Associates of The Focal Pointe may from time to time, have access to your health information. The Business Associates have the proper Business Associate Agreements in place, insuring the protection of your health information.
Upon the physicians best judgment, we may disclose to a family member, relative, or close person friend or any other persons you identify, health information relevant to that person’s involvement in your care.
Your information may be used for research data, funeral directors, organ procurement, FDA; public health or legal authorities; and/or law enforcement purposes.
APPOINTMENT REMINDERS
We may call to remind you with appointment reminders, cancellations, and may leave voice mail messages at your home or place of employment. We may send you an e-mail you with appointment reminders and cancellations. We may also notify you of other treatments or services available at our office that might help you.
OTHER DISCLOSURES
We will not make any other uses or disclosures of your health information unless you sign a written authorization form. You do not have to sign such a form. If you do sign one, you may revoke it at any time unless we have already acted in reliance upon it.
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