Dr. Rocheford and her staff respect our patient’s privacy and are dedicated to maintaining the confidentiality of your medical information. This policy describes how your medical information may be used and disclosed by the practice.
Use and Disclosure
Your Protected Health Information (PHI) will be used by the Practice and disclosed to others for the purpose of treatment, payment, healthcare operations, law enforcement, or for public health safety. The Practice will require your consent or authorization to disclose PHI for other purposes.
Notice of Privacy
The Practice will give you a Notice of Privacy about its policies for disclosure of PHI if requested in writing. You should review this document carefully. It recognized your rights as a patient and details how your PHI will be disclosed. You must sign this notice and receive a signed copy of the notice. If you decline not to acknowledge this notice, the Practice will not treat you.
Request for Restriction to Use or Disclose PHI
You may request a written restriction on the use and disclosure of your PHI. The Practice will agree to your request. It will not use or disclose the restricted PHI. Violation of this agreement will be a violation of the federal privacy standard.
Revocation of Authorization or Consent
You may revoke this consent by written statement at any time. The Practice will honor your request. Any use or disclosure of your PHI prior to this date will not be affected by this revocation.
Revocation of Right to Change Privacy Practice
he Practice reserves the right to modify the privacy practices outlined in the notice.