In these cases we never share your information unless you give us written permission:.We may also share your information when needed to lessen a serious and imminent threat to health or safety. If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. In these cases you have both the right and the choice to tell us to: share information with your family, close friends, or others involved in your care and share information in a disaster relief situation.If you have a clear preference for how we share your information in situations described below, talk to us. YOUR CHOICES - For certain health information, you can tell us your choices about what we share. If you tell us we can and then change your mind, just let us know in writing you have changed your mind. Not to use or share you information other what is described in this notice unless you tell us we can in writing.Follow the duties and privacy practices described in this notice and give you a copy of it.Notify you promptly if a breach occurs that may compromise the privacy or security of your information.Maintain the privacy and security of your protected health information.OUR RESPONSIBILITIES: The law requires us to: We will not retaliate for filing a complaint.File a complaint with the US Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Ave, S.W., Washington, D.C.If you feel your rights have been violated you may contact the designated Privacy Officer, Ask for a paper copy of this document even if you have agreed to receive the notice electronically.We will ask for proof of this relationship before we take any action. If you have given someone medical power of attorney or they are your legal guardian, that person can exercise your rights and make choices about your health information. Revoke an authorization to use or disclose PHI at any time except where action has already been taken.For additional requests we will charge a reasonable, cost based fee. One request per year will be provided free of charge. We will provide a list for the past six years for the request. Ask us for a list or an accounting of the times we have shared your health information for reasons other than treatment, payment, healthcare operations, and when you have asked us to share information.If you pay for a service or health care item out of pocket in full and you ask us not to share that information for payment or our operations with your health insurer we will agree unless we are required by law to share that information.We are not required to agree with your request and may say “no” if it would affect your care. Ask us not to use or share certain health information for treatment, payment or our operations.We will accommodate all reasonable requests. You can ask us to communicate with you in a certain way (for example, home or office phone) or to send mail to a different address.We may say “no” but will tell you why in writing within 60 days. Ask us to correct your health information you think is incorrect or incomplete.We will provide this information as soon as possible but no later than 30 working days of the request. We will charge a reasonable, cost based fee. We will also provide a summary of your health information if requested. Ask to see or get an electronic or a paper copy of your health record or other information we have about you.YOUR RIGHTS: When it comes to your health information you have certain rights. ![]() THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED BY AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. Salem Neurological Center Notice of Privacy Practices
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