Notice of Privacy Practices

Our Commitment to Your Privacy

Brigade Clinic is dedicated to maintaining the privacy of your protected health information (PHI). We are required by law to provide you with this notice of our legal duties and privacy practices. We will follow the terms of this notice and may change our practices in the future. Any changes will be effective for all PHI that we maintain.

How We May Use and Disclose Your PHI

The following categories describe different ways that we use and disclose your PHI. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

• For Treatment: We may use your PHI to provide you with medical treatment or services. We may disclose your PHI to doctors, nurses, technicians, or other personnel who are involved in taking care of you.
• For Payment: We may use and disclose your PHI so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company, or a third party.
• For Health Care Operations: We may use and disclose your PHI for our health care operations. These uses are necessary to run our clinic and make sure that all of our patients receive quality care.

Your Health Information Rights

You have the following rights regarding your PHI:

• Right to Inspect and Copy: You have the right to inspect and copy your PHI. To do so, you must submit your request in writing to our Privacy Officer.
• Right to Amend: If you feel that PHI we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the clinic.
• Right to an Accounting of Disclosures: You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of your PHI for purposes other than treatment, payment, or health care operations.
• Right to Request Restrictions: You have the right to request a restriction or limitation on the PHI we use or disclose about you for treatment, payment, or health care operations.
• Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with Brigade Clinic or with the Secretary of the Department of Health and Human Services. To file a complaint with us, please contact our Privacy Officer at the address and number below. All complaints must be submitted in writing. You will not be penalized for filing a complaint.