Privacy Statement

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
I. UNDERSTANDING YOUR HEALTH INFORMATION
Each time you visit our clinic, a record of your visit is created. This record usually contains your name and other information that may identify you, your symptoms, a description of your examination and test results, diagnoses, treatment, plan for future health care, and financial information. This record is sometimes referred to as your “medical record” or “medical chart.”

This record allows:

  • Our clinic’s Health Professionals to plan and communicate about your care

  • Our clinic to obtain payment for service provided

  • Our clinic to measure the quality of care provided to you

We are committed to keeping your health information confidential. We will not use or give to others your health information without your written permission, except as stated in this Notice.

II. HOW WE WILL USE AND GIVE OUT YOUR HEALTH INFORMATION:

a. TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS

We will use and give out your health information to provide you with health care treatments, to get paid for our services, and to help us operate our clinic. For example:

  • We will give your health information to health care professionals not on our staff, such as other doctors and hospital staff, who help care for you.

  • We may send a bill to your health insurance plan or to you

  • Our clinic may use your medical record to review our performance and make sure you receive quality health care
b. OTHER USES AND DISCLOSURES ALLOWED OR REQUIRED BY LAW

We may use or give out your health information for the following purposes under limited circumstances:

  • To people who are involved in your care or who help pay for your care, such as your family, your close personal friends, or any other person chosen by you, to notify them of your location, general health, and to assist you in your health care (such as to pick-up medicine or help with follow-up care);

  • To government agencies that oversee our clinic (such as license and certification inspectors);

  • To government agencies that have the right to receive and collect health information (such as to control disease outbreaks);

  • When we are ordered by a court or judge;

  • To workers’ compensation programs when your health problem is from a work-related injury;

  • When law enforcement requests information (such as to prevent danger or injury);

  • To coroners and funeral directors to allow them to carry out their duties;

  • To organ donor agencies (subject to applicable laws);

  • To avoid a serious threat to the health or safety of others;

  • To contact you about new treatments or medicines that may help you.

  • To business associates of the clinic that help us perform required tasks, such as our accountants, computer consultants, and billing companies (only if the business associate agrees in writing to keep your health information confidential as required by law); and
III. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
Subject to certain legal limits, you have rights regarding the use and disclosure of your health information, including the rights to:

  • Request limits on uses of your health information

  • Receive confidential communications of your health information

  • Inspect and copy your health information

  • Request a change to your health information

  • Receive a record of how we have used and given out your health information

  • Obtain a copy of this Notice of Privacy Practices
IV. QUESTIONS, CONCERNS, AND CHANGES TO THIS NOTICE

If you have any questions or want to talk about any of the information in this Notice of Privacy Practices, please contact the Office Manger at 18323 98th Avenue NE; Bothell, WA 98011 425-806-4600.

If you believe your privacy rights have been violated, you may file a complaint with our clinic or with the Secretary of the Department of Health and Human Services. To file a complaint with our clinic, submit it to the Office Manager at 18323 98th Avenue NE; Bothell, WA 98011. All complaints must be submitted in writing. We will not retaliate against you for filing a complaint.

We may change our Notice of Privacy Practices in the future. Such changes will apply to your health information that we created or received before the effective date of the change. We will notify you of any changes to our Notice of Privacy Practices by posting the changed notice at our clinic.