Notice of Privacy Policy
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.
Your Rights with Respect to Health Information
Right to Inspect and Copy Your Health Information
You have the right to inspect and copy your health information, with certain exceptions. If you request copies of information, we may charge a fee for costs associated with your request, including the cost of copies, mailing, or other supplies.
Right to Request Information in Certain Form and Location
You have the right to request health information in a certain form or at a specific location. For instance, you can request that we not contact you at work. The request must tell us how and/or where you want to receive information. We will accommodate reasonable requests.
Right to Request Amendment to Your Health Information
You have the right to request that your health information be amended if you believe that it is incorrect or incomplete. You must provide the reason that you want the amendment added to your health information. Your request must be in writing.
Right to Accounting of Disclosures
You have the right to receive an accounting of disclosures of medical information that we have made, with some exceptions. You have the right to receive one (1) free accounting every twelve (12) months. If you request more than one (1) accounting in any twelve-month period, we may charge you a reasonable fee for the costs of providing that list.
Right to Request Restrictions
You have the right to request that we restrict any use or disclosure of your health information. If we agree to your restriction, we will comply with your request. For example, a patient who does not want his or her physician to share health information with other physicians involved in his or her care may request to restrict such disclosure. We are not required to accept any restriction that you request.
Federal law gives all patients a right to a paper copy of this Notice. If you have agreed to receive this Notice in another form, you can still request a paper copy of this Notice. To obtain a paper copy of this Notice or to submit a written request related to “Your Rights,” contact Angels On Duty, Inc.
Privacy Complaints
If you have any questions about the content of this Notice, or if you need to contact someone regarding the privacy of your health information, please contact:
Phone: 636.980.HALO (4256) or 636.294.WING(9464)
You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint with either Angels On Duty, Inc. or the U.S. Department of Health and Human Services.
Other Uses or Disclosures
If you provide us with written authorization to use or disclose your health information, you can change your mind and revoke your authorization at any time, as long as you revoke your authorization in writing. If you revoke your authorization, we will no longer use or disclose the information, but we will not be able to take back any disclosures that we have already made.
Changes to This Notice
We reserve the right to change or modify the information contained in this Notice.