Notice of Privacy Practices

 

TREATMENT PRIVACY INFORMATION

 

NOTICE OF PRIVACY PRACTICES

 

This Notice describes how your medical information may be used and/or disclosed, and how you may access this information.  

 

TheraCare Community Center (TCC) has a legal responsibility to protect your medical information.  Protected Health Information (PHI) is information about you that may identify you in that it relates to your past, present or future physical, mental health, condition, and/or related health care services; including demographic information.

 

Uses and/or Disclosures of Your PHI Without Your Authorization

 

• Treatment

• Payment

• Healthcare Operations

• Other Legally Mandated Uses and/or Disclosures

 

Any Other Use or Disclosure of Your PHI Requires Your Written Authorization

 

YOUR RIGHTS

 

To request restrictions of the uses and/or disclosures of your PHI.

To request to receive confidential communications from TCC by alternative means, or at an alternative location.

To inspect and copy your PHI.

To request amendment of your PHI to receive an accounting of disclosures made by TCC of your PHI.

To obtain a paper copy of this complete Notice.

 

You May Object to the Use and/or Disclosure of Your PHI.  You also may complain about the privacy practices at TCC.  Please contact the Privacy Officer at: 954-256-4601.

 

You may also send a written complaint to the United State Secretary of the Department of Health and Human Services.  If you file a complaint, we will not take any action against you or change our treatment of you in any way.

 

I understand that video cameras are utilized on TheraCare Community Center premises for safety and security purposes.