Privacy Notice
EFECTIVE DATE OF NOTICE: APRIL 14, 2003
NOTICE OF PRIVACY PRACTICES
CHRISTOPHER P. CIAMPA O.D. INC.
DBA:CIAMPA VISION CENTER
This notice describes how your health information may be used and disclosed and how you can access this information. Please review carefully.
At Ciampa vision center, we have always kept your health information secure
and confidential. A new law require as to keep maintaining your privacy, to give this notice and to follow the terms of this notice.
The law permits as to use or disclose your health information to those involved in your treatment, for example a review of your file by a specialist doctor whom we may involve in your care.
You may request in writing that we may not use or disclose your health information as described above. We will know if we can fulfill your request.
You have the right to know of any uses or disclosures we make with your health information beyond the above normal uses.
As we need to contact you from time to time, we will use whatever address or telephone number you prefer.
You have the right to transfer copies of your health information to another practice. We will mail your files to you.
You have the right to see and receive a copy of your health information, with a few exceptions. Give us a written request regarding the information you want to see. If you also want a copy of your records, we may charge you a reasonable fee for the copies.
You have the right to request amendment or change to your health information. Give as your request to make changes in writing. If you wish to include a statement in your file, please give it to us in writing. We may or may not make the changes you request, but we will be happy to include the statement in your file. If we agree to amendment or change we will not remove nor alter earlier documents, but will add a new information.
You have the right to receive a copy of this notice.
If we change any of the details of this notice, we will notify you of the changes in writing.
You may file a complaint with the department of health and human recourses,
200 Independence Ave, S.W., Room 509F, Washington, DC 20201. You will not be retaliated against for filing a complained.
However before filing a complaint, or for more information or assistance regarding your health information privacy, please contact our privacy officer.
NOTICE OF PRIVACY PRACTICES
CHRISTOPHER P. CIAMPA O.D. INC.
DBA:CIAMPA VISION CENTER
This notice describes how your health information may be used and disclosed and how you can access this information. Please review carefully.
At Ciampa vision center, we have always kept your health information secure
and confidential. A new law require as to keep maintaining your privacy, to give this notice and to follow the terms of this notice.
The law permits as to use or disclose your health information to those involved in your treatment, for example a review of your file by a specialist doctor whom we may involve in your care.
- We may use or disclose your health information for payment or services, for example we may send a report of progress to your insurance company.
- We may use or disclose your health information for our normal health care operations, for example one of our staff will enter your information in our computer.
- We may share your medical record with our business associates, such as billing services. We have a written contract with each business associate that requires them to protect your privacy.
- We may use your information to contact you, for example, we may send a newsletters or other information. We also want to call and remind you about your appointments. If you are not home we may leave this information on your answering machine or with the person who answers the telephone.
- In an emergency, we may disclose your health information to a family member or another person responsible of your care.
- We may release some or all of your health information when required by law. If this practice is sold, your information will become the property of the new owner. Except as described above, this practice will not use or disclose your health information without your prior written authorization.
You may request in writing that we may not use or disclose your health information as described above. We will know if we can fulfill your request.
You have the right to know of any uses or disclosures we make with your health information beyond the above normal uses.
As we need to contact you from time to time, we will use whatever address or telephone number you prefer.
You have the right to transfer copies of your health information to another practice. We will mail your files to you.
You have the right to see and receive a copy of your health information, with a few exceptions. Give us a written request regarding the information you want to see. If you also want a copy of your records, we may charge you a reasonable fee for the copies.
You have the right to request amendment or change to your health information. Give as your request to make changes in writing. If you wish to include a statement in your file, please give it to us in writing. We may or may not make the changes you request, but we will be happy to include the statement in your file. If we agree to amendment or change we will not remove nor alter earlier documents, but will add a new information.
You have the right to receive a copy of this notice.
If we change any of the details of this notice, we will notify you of the changes in writing.
You may file a complaint with the department of health and human recourses,
200 Independence Ave, S.W., Room 509F, Washington, DC 20201. You will not be retaliated against for filing a complained.
However before filing a complaint, or for more information or assistance regarding your health information privacy, please contact our privacy officer.
