NOTICE OF PRIVACY PRACTICES

This notice describes how medical / protected health information about you may be used and disclosed and how you can get access to this information. Please Review carefully.

Summary:

By the law, we are required to provide you with our Notice of Privacy Practices (NPP). This notice describes how your medical information may be used ad disclosed by us:

1. The right to inspect and copy your information;
2. The right to request corrections to your information;
3. The right to request that your information be restricted;
4. The right to request confidential communications;
5. The right to report of disclosures of your information; and
6. The right to a paper copy of this Notice.

We want to assure your that your medical / protected health information is secure with us. This Notice contains information about how we will ensure your information remains private.

If you have any questions about this Notice, the name and phone of contact persons is listed on this page.

“I hereby acknowledgement that I have a copy of this practice’s NOTICE OF PRIMARY PRACTICE!”.

Understand that if I have a questions or complaints regarding my privacy rights that I may contact the person listed above. I further understand that the practice will offer me updated to this NOTICE OF PRIMARY PRACTICE should it be amended modified of change in any way “