Patient Privacy Policy and Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Please Review This Information Carefully

We understand that medical information about you and your health is private and personal. The Staff of Harmony Event Medicine is committed to protecting medical information about you. This notice applies to the information and records we have about your health, health status, health care and services you received from Harmony. Your health information may include health information created by Harmony, may be in the form on written or electronic records or spoken words, and may include information about your health history, health status, symptoms, examinations, treatments, and similar types of health related information.

This notice describes the information privacy practices followed by our staff and other personnel. We are required by law to maintain the privacy of your protected health information, provide you this notice and abide by the terms of this notice.

This notice will tell you about the ways in which we use and disclose health information about you and describe your rights and our obligations regarding the use of that information.

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

We may use and disclose health information about you for the purposes of treatment, and/or healthcare operations without requesting or obtaining your consent or authorization. The following is a non-exhaustive list provided as examples of how the information may be used for treatment, and/or healthcare operations.

• FOR TREATMENT. We may share health information about you to provide you with medical services. We may disclose health information about you to doctors, nurses, technicians, hospital staff, office staff and/or any other medical personnel involved in taking care of you and your health.

For example, if you are participating at an event that Harmony is providing services, and you fall ill and are unable to voice your desire for immediate outside care, Harmony would call for 911 services and relay pertinent information about you and your health to arriving 911 personnel.

Family members and other health care providers may be part of your medical care outside Harmony Event Medicine and may require information about you and your health that we may have.

• FOR HEALTH CARE OPERATIONS . We may use your health information for operations and activities such as quality control, quality assurance, and financial planning to help us provide efficient and quality care for you and others.
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• FOR IDENTITY THEFT PROTECTION. We may collect copies of your government-issued identification or other documents at the time of service in order to verify your identity and to prevent identity theft.

SPECIAL SITUATIONS

We may use or disclose health information about you for the following purposes, subject to all legal requirements and limitations:

• TO AVERT A SERIOUS THREAT TO HEALTH AND SAFETY. We may use to disclose health information about you when necessary to prevent a serious threat to your health and safety or to the health and safety of the public or another person.
• PUBLIC HEALTH RISKS. We may disclose health information about you for public health reasons in order to prevent or control disease, injury or disability; or report births, deaths, suspected abuse or neglect, non-accidental physical injuries, reactions to medications or problems with products.
• HEALTH OVERSIGHTS ACTIVITIES. We may disclose health information to an oversight agency for audits, investigations, inspections, or licensing purposes. These disclosures may be necessary for certain state and federal agencies to monitor the health care system, government programs, and compliance with civil rights laws.
• LAWSUITS AND DISPUTES. IF you are involved in a lawsuit or dispute, we may disclose healthcare information about you in response to a court or administrative order. Subject to all legal requirements, we may also disclose health information about you in response to a subpoena.
• LAW ENFORCEMENT. We may release health information if asked to do so by a law enforcement official in response to a court order, subpoena, warrant, summons or similar process, subject to all legal requirements.
• CORONERS, MEDICAL EXAMINERS AND FUNERAL DIRECTORS. We may release health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine cause of death.
• INFORMATION NOT PERSONALLY IDENTIFIABLE. We may use or disclose health information about you in a way that does not personally identify or reveal who you are. For example, we may provide health statistics to festival or concert organizers.
• FAMILY AND FRIENDS. We may disclose health information about you to your family members or friends if we obtain your written agreement to do so, or if we give you an opportunity to object to such a disclosure and you do not raise an objection. We may also disclose your information to family or friends if we can infer from circumstances based on our judgment that you would not object. For example, we may assume you agree to our disclosure of your personal health information to your spouse when you bring your spouse into the examination area or while services are discussed.

In situations where you are not capable of giving consent (because you are not present or incapacitated due to medical emergency) we may, using our judgment, determine that disclosure to a family member or friend is in your best interest. In that situation, we will disclose only health information relevant to the person involved in your care. For example we may share information with the person who accompanied you into the exam area and provide updates and progress reports. We may also make inferences to that person to make arrangement on your behalf to pickup medical supplies, etc for aftercare.

You may, from time to time, share with us photographs of yourself or children, which are posted in our public spaces or areas. We will assume, unless you provide written instructions indicating otherwise, any photographs are available to us for public display.

OTHER USES AND DISCLOSURES OF HEALTH INFORMATION

Other uses and disclosures of health information not covered by this notice or the laws that apply to use will only be made with your written authorization. If you provide us authorization to use or disclose medical information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reason covered by your written authorization, but we cannot take back any uses or disclosures already made with your authorization.

In some instances, we may need specific, written authorization from you in order to disclose certain types of specially protected information such as HIV, substance abuse, mental health, or other information.

YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU

You have the following rights regarding health information we maintain about you:

• RIGHT TO INSPECT AND COPY. You have the right inspect and copy your health information that may be used to make decisions about your care.
• All requests must be in writing.
• If you request a copy of the information, we may charge a fee for the costs associated with the request.
• RIGHT TO AMEND. If you believe health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to amend as long as the information is kept by this organization.

To request the amendment, submit the request to the Privacy Officer at the address above.

We may deny the request if it is not in writing or there is not sufficient enough reason to support the request. In addition we may deny if:

a) We did not create the information

b) Is not part of the health information we keep

c) If it is information you are not permitted to inspect and copy

d) Is accurate and complete

• RIGHT TO AN ACCOUNTING OF DISCLOSURES. You have the right to request an “accounting of disclosures.” This is the list of disclosures we have made of medical information about you for purposes other than assessment, treatment, operations, and limited number of special circumstances involving national security, corrections and/or law enforcement. The list will exclude disclosures we have made based on your written authorization. To obtain this list, please contact the Privacy Officer listed above. We will notify you of the costs involved and you may choose to withdraw or modify your request at that time before any costs incurred.
• RIGHT TO REQUEST RESTRICTIONS. You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment or operations. You also have the right to request a limit on the health information we may disclose about you to a friend or family member involved in your care. For example you may ask we not disclose information that may cause embarrassment or complicate a relationship.

We are not required to agree to your request. If we do agree, we will comply unless the information is needed to provide you emergency care or we are required by law to use or disclose the information.

To request restrictions, please contact the Privacy Officer at the address above.

• RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS. You have the right to request that we may communicate with you about medical matters a certain way or at a certain location. For example, you may request that we only contact you at work or by mail or via your Lawyer.

To request confidential communication, please contact the Privacy Officer at the address above.

• RIGHT TO BE NOTIFIED OF A BREACH. You have the right to be notified in the event that we (or a Business Associate) discover a breach of unsecured protected health information about you that results in significant risk of financial or reputational harm.

CHANGES TO THIS NOTICE

We reserve the right to make changes to this notice at any time. We will post the most current copy of this notice on our website with the effective date in the upper right hand corner on the front page. You are entitled to a copy of this notice, in Paper, if you request one.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with Harmony Event Medicine.

If you have any questions about this notice or our privacy practices, please contact: harmonyeventmedicine@gmail.com

You may also contact the Secretary of the Federal Department of Human Services. All requests must be submitted in writing. We will not take any action against you for filing a complaint.