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 THIS NOTICE CAREFULLY.

Your health record contains personal information about you and your health. State and federal law protects the confidentiality of this information. "Protected Health Information" (PHI) is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.

Your Rights Regarding Your PHI

You have the following rights regarding PHI I maintain about you:

My Uses and Disclosures of PHI for Treatment, Payment and Health Care Operations

Other Uses and Disclosures That Do Not Require Your Authorization or Opportunity to Obiect

Uses and Disclosures of PHI With Your Written Authorization

Other uses and disclosures of your PHI will be made only with your written authorization. You may revoke this authorization in writing at any time, unless I have taken an action in reliance on the authorization of the use or disclosure you permitted, such as providing you with health care services for which I must submit subsequent claim(s) for payment.

This Notice of Privacy Practices describes how I may use and disclose your protected health information ("PHI") in accordance with all applicable law. It also describes your rights regarding how you may gain access to and control your PHI. I am required by law to maintain the privacy of PHI and to provide you with notice of my legal duties and privacy practices with respect to PHI. I am required to abide by the terms of this Notice of Privacy Practices. I reserve the right to change the terms of my Notice of Privacy Practices at any time. Any new Notice of Privacy Prdctices will be effective for all PHI that I maintain at that time. I will make available a revised Notice of Privacy Practices by posting a copy on my Web site at http://home.earthlink.net/~lynn.fitzhugh/privacy.html.

Contact Information

I am my own Privacy Officer. So, if you have any questions about this Notice of Privacy Practices, please contact me. My contact information Is: 1424 N.E. 155th St. #204, Shoreline, WA 98115, 206-713-497, lynn.fitzhugh@earthlink.net.

Complaints

If you believe I have violated your privacy rights, you may file a complaint in writing to me, as my own Privacy Officer, specified on the first page of this Notice. I will not retaliate against you for filing a complaint. You may also file a complaint with the U.S. Secretary of Health and Human Services at 200 Independence Avenue, S.W., Washington, D.C. 20201 - (202) 619-0257.

The effective date of this notice is April 14, 2003.

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