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![Privacy Policy of Optimal Health & Aesthetics [Flagstaff, Arizona]](../images/titleheads/Privacy-Policy.jpg) |
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| Notice of Privacy
Practices for Optimal Health & Aesthetics |
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| To our Patients: This
notice describes how health information about you (as a
patient of this practice) may be used and disclosed, and
how you can get access to your health information. This
is required by the Privacy Regulations created as a
result of the Health Insurance Portability and
Accountability Act of 1996 (HIPAA). |
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| Our commitment to your
privacy: Our practice is dedicated to maintaining the
privacy of your health information. We are required by
law to maintain the confidentiality of your health
information. |
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| The following
circumstances may require us to disclose your health
information without your authorization or consent: |
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1. As required by law with respect to
victims of abuse, neglect, or domestic
violence. |
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2. If required to do so by a law enforcement
official. |
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3. When necessary to reduce or prevent a
serious threat to your health and safety or
the health and safety of another individual
or the public. |
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4. Lawsuits and similar proceedings in
response to a court or administrative order. |
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5. If you are a member of the U.S. or
foreign military forces (including veterans)
and if required by the appropriate
authorities. |
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6. To the U.S. Department of State as it
relates to obtaining security clearance. |
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7. To federal officials for intelligence and
national security activities authorized by
law. |
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| Your rights regarding
your health information: |
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1. Communications: You may request that we
communicate with you in a particular manner;
for example, you may request that we call
you at home rather than work. You may
request that we restrict our disclosure of
your health information to only certain
individuals involved in your care, such as
family members or friends. We, however, are
not required to agree to your request. |
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2. Medical records: You may obtain a copy of
your medical records. You may request to
amend your health information if you believe
it is incorrect or incomplete. Your request
must be made in writing with a reason that
supports your request for amendment. We,
however, are not required to agree to your
request. |
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3. Complaints: You may file a complaint if
you believe your privacy rights have been
violated. You may file your complaint with
Dr. Brownsberger’s office manager or with
the Secretary of the Department of Health
and Human Services. Your complaint must be
submitted in writing. |
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4. Copy: You have the right to receive a
copy of this Notice of Privacy Practices.
Copies are available at the front desk. |
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5. Authorization: You have the right to
provide authorization for other uses and
disclosures that are not identified by this
notice. Our office will obtain your written
authorization before we release any
information not identified by this notice or
permitted by applicable law. |
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OPTIMAL HEALTH
& AESTHETICS |
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Skin Care & Anti-Aging Doctor |
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1360 North Rim Drive
Flagstaff, Arizona 86001 |
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Phone: 928-214-7005
Fax: 928-214-8855 |
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