Effective Date: May 15, 2025
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Obligations
We are required by law to:
- Maintain the privacy of protected health information
- Give you this notice of our legal duties and privacy practices regarding health information about you
- Follow the terms of our notice that is currently in effect
- Notify you following a breach of unsecured protected health information
How We May Use and Disclose Health Information
For Treatment
We may use and disclose Health Information for your treatment and to provide you with treatment-related health services, including heat vulnerability risk assessments and recommendations to reduce health risks during extreme heat events.
For Research
We may use and disclose Health Information for research purposes. Before we use or disclose Health Information for research, the project will go through a special approval process. Even without special approval, we may permit researchers to look at records to help them identify patients who may be included in their research project or for other similar purposes, as long as they do not remove or take a copy of any Health Information.
As Required by Law
We will disclose Health Information when required to do so by international, federal, state or local law.
Your Rights
Right to Inspect and Copy
You have a right to inspect and copy Health Information that may be used to make decisions about your care or payment for your care. This includes medical and billing records, other than psychotherapy notes.
Right to an Electronic Copy of Electronic Medical Records
If your Health Information is maintained in an electronic format, you have the right to request that an electronic copy of your record be given to you or transmitted to another individual or entity.
Right to Amend
If you feel that Health Information we have is incorrect or incomplete, you may ask us to amend the information.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures we made of Health Information for purposes other than treatment, payment and health care operations or for which you provided written authorization.
Right to Request Restrictions
You have the right to request a restriction or limitation on the Health Information we use or disclose for treatment, payment, or health care operations.
Right to Request Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.
Right to a Paper Copy of This Notice
You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time.
Changes to This Notice
We reserve the right to change this notice and make the new notice apply to Health Information we already have as well as any information we receive in the future. We will post a copy of our current notice on our website.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with us, contact our Privacy Officer. All complaints must be made in writing. You will not be penalized for filing a complaint.
Contact Information
For more information about our privacy practices, or to file a complaint, please contact:
Privacy Officer
Email: privacy@promptedvisions.com
Phone: (555) 123-4567