Notice of Privacy
Patient’s Protected Health Information
This notice describes how health care information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
This office abides by the terms described in this policy. This office uses and discloses your protected health care information for the following reasons:
To share with other treating health care providers regarding your health care.
To submit to insurance companies or Workers’ Compensation Claim to verify that treatment has been rendered.
To determine patients benefits in a health care plan.
Releasing information required by State or Federal Public Health Law.
To assist in overcoming a language barrier when caring for a patient.
Written assurances for your privacy have been attained from business associates.
Emergency situations.
Abuse, neglect, or domestic violence.
Appointment reminders to household members or answering machines.
Information about alternatives to your present care or other health related information that may be of interest to you.
Sign-In logs may be disclosed to verify office visits.
Any other uses or disclosures will only be made with your specific written prior authorization.
You have the right to:
Revoke authorization, in writing at any time by specifying what you want restricted and to whom.
Speak to our privacy officer who is Dr. Richard Shand, DC and can be reached at: 242 Whipple St., Ste. 2, Prescott AZ 86301. Telephone (928) 800-2009 regarding privacy issues.
Inspect, copy, and amend your protected health information.
Releasing information required by State or Federal Public Health Law.
To render a complaint to our privacy officer or the Secretary of Health and Human Services.