HIPAA PRIVACY STATEMENT
Who is covered by this notice: This notice applies to our medical facility and any programs associated with Skin Secrets Cosmetic Clinic.
WE ARE OBLIGATED BY LAW TO:
CHANGES TO THIS NOTICE
If you believe that your privacy rights have been violated, you can file a complaint with our facility or directly with the United States Department of Health and Human Services: Office for Civil Rights, located at 200 Independence Avenue, S.W., Washington D.C. 20201. Toll-Free: (877) 696-6775. You can also visit www.hhs.gov/ocr/privacy/hipaa/complaints/ for more information. To file a complaint with our facility, please submit a written complaint within 180 days of the suspected violation to email@example.com . Please include as much detail as possible about the incident.
USE AND DISCLOSURE OF YOUR MEDICAL INFORMATION:
Communication with family: Involving your family or personal friends in your care, we may disclose relevant health information to them. In emergency situations or when you are unable to object, we may disclose your information in your best interest. After an emergency, you will be informed of the disclosure and given the opportunity to object to further disclosures.
YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION:
Right to inspect and copy: You have the right to review and receive a copy of your medical information maintained by our facility. To request access, please submit a written request to firstname.lastname@example.org or to our address provided. We may charge a reasonable fee for copying and associated supplies.
Right to amend: If you believe that your medical information is incorrect or incomplete, you may request an amendment. Your request must be made in writing, explaining the reason, and submitted to email@example.com or our address provided. We may deny your request under certain circumstances.
Right to accounting of disclosures: You have the right to request a list of disclosures we have made of your medical information. Your request should be in writing, specifying the desired time period, and sent to firstname.lastname@example.org or our address provided. Additional accountings may incur a fee.
Right to request confidential communications: You have the right to request confidential communication regarding your medical matters. To make this request, please submit it in writing to email@example.com or our address provided, specifying the desired communication method.
Right to request restrictions: You have the right to request restrictions on the use or disclosure of your medical information for treatment, payment, or healthcare operations. We are not obligated to agree to your request, except in certain circumstances. To request restrictions, please submit your written request to firstname.lastname@example.org or our address provided.
Right to a copy of this notice: You have the right to request a paper copy of this notice at any time. To obtain a copy, please submit your request in writing to email@example.com or our address provided.