Last updated: this is a template — review with counsel before launch.
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.
Uses and disclosures
We may use and disclose your protected health information (PHI) for treatment, payment, and health care operations, and as otherwise permitted or required by law.
Your rights
You have the right to inspect and copy your PHI, request amendments, request restrictions on certain uses and disclosures, request confidential communications, and receive an accounting of certain disclosures.
Our responsibilities
We are required by law to maintain the privacy of your PHI, provide this notice of our duties and privacy practices, and notify you following a breach of unsecured PHI.
Contact
To exercise your rights or file a complaint, contact our privacy officer. You will not be retaliated against for filing a complaint.
This document is a starting template provided as part of a demonstration build. It is not legal advice. Have a qualified healthcare-regulatory attorney review and finalize all legal and consent documents before operating.