When it comes to your health information, you have certain rights. Here's what you’re entitled to and what I’m responsible for:

Get a copy of your records

You can request an electronic or paper copy of your records and other health information. Just ask, and I’ll provide a copy or summary within 20 days. A reasonable, cost-based fee may apply.

Request a correction

If you believe any health information I have about you is incorrect or incomplete, you can request a correction. I’ll explain the process when you ask.

Request confidential communication

You can ask to be contacted in a specific way (e.g., only by email, or at a different address). I’ll say “yes” to all reasonable requests that align with my ethical responsibilities.

Limit what I share

You can ask me not to share certain information for payment or operations. If you pay out-of-pocket in full, you can request that I don’t share that info with your insurance provider.

Request a paper copy of this notice

You’re welcome to a printed copy at any time even if you originally agreed to receive it electronically.

Appoint someone to act for you

If you’ve granted someone legal authority (like medical power of attorney or guardianship), that person can act on your behalf regarding your health info. I’ll verify that authority before taking action.

File a complaint

If you believe your rights have been violated, you can file a complaint directly with me—or with the U.S. Department of Health & Human Services:

U.S. Department of Health and Human Services
200 Independence Avenue SW

Washington, D.C. 20201
1-877-696-6775
www.hhs.gov/ocr/privacy/hipaa/complaints

I will never retaliate against you for filing a complaint.