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This statement is provided to comply with the privacy and security rules as per the health insurance portability and accountability act (HIPAA).
In our clinic we have open walled rooms. We make every effort to moderate our voices for your confidentiality. Should you have any problem with this we do have closed offices to discuss your case.
In our clinic we have an open therapy room where therapy and rehabilitation is performed. All efforts to preserve your confidentiality are made. If you have any reservations about the open therapy area, please make them known to the staff.
It is Blackstone Chiropractic Clinics legal duty to protect a patient's privacy at all times. It is also required that we provide notice of this privacy policy to the patient and we adhere to that notice.
If there are any changes made to this policy those changes will be posted and the patient will be notified in writing.
PATIENT'S BILL OF RIGHTS
As a patient in our clinic you have the right to:
1. Receive a copy of your protected health information (PHI).
2. Read and have a copy* of the notice of privacy practices and patient rights.
3. Request a restriction on how your PHI is used or disclosed.
4. Inspect and receive a copy out of your PHI.
5. Request amendments and corrections to the record.
6. Request accounting and disclosure to which your PHI has been sent.
7. Request confidential communications.
*a first copy of your complete PHI will be free and will take up to 72 hours to complete.
Privacy is waived with certain conditions. Those conditions are:
" As required by law;
" for public health activities;
" for disclosures about abuse, neglect, or domestic violence;
" for use by health oversight activities;
" for judicial and administrative proceedings;
" for law enforcement purposes;
" to coroners, medical examiners, and funeral directors for the purpose out of identification, identifying cause of death, or for other duties as authorized by law;
" for uses and disclosures for organic, eye, or tissue donation purposes;
" for uses and disclosures for research purposes;
" for uses and disclosures to avert a serious threat to health and safety;
" for uses and disclosures for specialized government functions;
" for uses and disclosures for workers compensation.
A complete explanation is available for all of the above waivers upon request.
If you feel you privacy has been violated by anyone in this office you may file a complaint with Dr.
Edward Olff. If you are not satisfied with the manner in which this office handles your complaint, you may submit a formal complaint to the Health and Human Services secretary
Edward P. Olff, D.C.
5665 North Blackstone #107
Fresno, California 93710
(599) 449-9777
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201
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