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.

DISCLOSURE OF INFORMATION
We may disclose information to other healthcare professionals and/or your insurance carrier for treatment, payment or healthcare operations. Additional disclosures may be necessary to comply with Workers' Compensation and Public Health Laws as well as Judicial proceedings.   We may contact a family member or other authorized person in consent unless compelled to do so by legal authority. Further you will be contacted by phone or mail in the event that a request for information is made.

APPOINTMENT REMIDER
It is our policy to call your home on the evening prior to your scheduled appointment to remind you of your appointment time. If you are not at home we leave a message on you're answering machine or with the person answering the phone. We will not leave any message that discloses confidential information. If you would like to use an alternate contact number please inform us of the number you would prefer.

FACILITY SET UP
While our examinations and treatment rooms are private, this office utilizes an open exercise/rehabilitation setting. Staff and doctors will maintain policies to ensure privacy, but there may be some inadvertent disclosures to others in the facility at the same time. If there is private information that you need discussed please request to have such discussions in a private room.

YOUR RIGHTS
• Send us a written request to see or procure a copy of the information that we have about you, or amend your personal information that you believe is incomplete or inaccurate. If we did not create the information, we will refer you to the source, such as other doctors or hospitals.

•  Request additional restrictions on uses and disclosures of your heath information. We are not required to agree to these requests and in some instances they may be prohibited by law.

• Request that we communicate with you about medical matters using reasonable alternative means or at an alternative address.

•  Receive an accounting of our disclosures of your medical information, except when those disclosures are made for treatment, payment or health care operations, or the law otherwise restricts the accounting.

•  You have the right to inspect and have a copy of your heath information. There is no cost for the first copy and any copy thereafter will be $25.

•  You have the right to amend your information. Please note that we have the right to disagree with your amendments. If there is disagreement you will be provided with information about our denial of your amendment and how you may appeal the denial of amendment.

•  You have the right to a copy of the notice upon request.

COMPLAINTS
Complaints about your privacy rights or how your privacy is handled at this office can be directed to J.R. Privacy by calling this office or directing a letter to his attention. If you are not satisfied with how this office handles your complaint you may submit a formal complaint to:

DHHS (Office of Civil Rights)
200 Independence Ave., S.W.
Room 509F HHH Building
Washington, D.C. 20201