THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
The terms of this notice apply to protected health information created or received by Washburn Center. Washburn Center providers will gather health information about you and/or your family. We use the information to establish a diagnosis, determine your treatment plan and goals, process payment, and provide the services you request. You are not required to provide us with health information; however, we may not be able to provide services without it. We are required to keep records of the care that we provide to you.
Except as described in this Notice, Washburn Center will not use or share your health information without specific written permission from you. If you provide us with written permission to use or share health information about you, you may take back that permission, in writing, at any time. If you take back your permission, we will no longer use or share health information about you, except to the extent we have already used or shared information based on the permission you previously gave. We are unable to take back anything we already shared with your permission.
If you feel your rights have been violated, see page 4 for details on how to file a complaint.
- We are required by law to maintain the privacy and security of your protected health information
- We will promptly tell you if the privacy or security of your information has been compromised, such as a data breach
- We must follow the duties and privacy practices described in this notice
Your Rights (for more details, see page 2)
- Review and receive a copy of health records (with some exceptions)
- Request changes to health records (we may or may not approve such requests)
- Request a list of when Washburn Center has shared certain health information about you/your child
- Request limitations on how we use/share health information (we may or may not approve such requests)
- Request confidential communication of health information
- Receive a paper copy of this notice
- Minors can request health information not be shared with parents (we may/may not approve requests)
How we may use or share your information (for more details, see page 3)
- Treatment, payment, and health care operations
- Appointment reminders
- Sharing health information with people helping you with your healthcare
- As required by law
- In situations where you or others are in danger or are being harmed (mandated reporting, duty to warn)
- To our business partners that help us perform job duties
Special situations where we may use your information (for more details, see page 4)
Organ and tissue donation, workers compensation, public health, health oversight, lawsuits and disputes, law enforcement, coroner/medical examiner/funeral director, special government functions (secret service, military)