Uses and Disclosures of Protected Health Information for Treatment, Payment and Health Care Operations

Uses and Disclosures that may be Made With Your Written Authorization

Uses and Disclosures that may be Made Unless You Object

Disclosures that may be Made Without Your Authorization or Opportunity to Object

Your Rights Regarding Your Protected Health Information

Making a Complaint
 

USES AND DISCLOSURES THAT MAY BE MADE WITH YOUR WRITTEN AUTHORIZATION

Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke such an authorization, at any time, in writing, except to the extent that your physician or the practice has taken an action in reliance on the use or disclosure indicated in the authorization.

This notice was published and becomes effective on April 1, 2003.