Notice of Privacy Practices

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.

[This page is a structural draft. The practice’s attorney or compliance officer must supply the final text before launch.]

Our commitment

SALUS Sports & Internal Medicine is required by law to keep your protected health information private, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.

How we may use and disclose your information

Treatment

We may use your health information to provide care and share it with other clinicians involved in your care, such as a referring physician or physical therapist.

Payment

We may use and share your information to bill and collect payment for services. [confirm: cash-pay practice, insurance participation]

Health care operations

We may use your information to run the practice, improve the quality of care and measure outcomes.

Appointment reminders and scheduling

We may contact you by phone, text or email about appointments. Reminders will not include the reason for your visit.

Other uses

We may share information when required by law, for public health activities, to avert a serious threat to health or safety, or as otherwise permitted by HIPAA. Other uses require your written authorization, which you may revoke at any time.

Your rights

• To inspect and receive a copy of your medical record.
• To request a correction to your record.
• To request restrictions on how we use or share your information.
• To request confidential communications by a particular method or at a particular location.
• To receive a list of certain disclosures we have made.
• To receive a paper copy of this notice.
• To be notified if a breach affects your information.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer at 7220 Avenida Encinas, Suite 125, Carlsbad, CA 92011, +1 (858) 585-4110 [confirm Privacy Officer name], or with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

Changes to this notice

We may change this notice and make the new notice apply to information we already hold. The current notice is posted in our office and on this page.