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 IT CAREFULLY.
Our Responsibilities
SKINAESTHETICA INC. is required by law to:
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Maintain the privacy and security of your protected health information (PHI)
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Provide you with this Notice of Privacy Practices
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Follow the duties and privacy practices described in this Notice
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Notify you promptly if a breach occurs that may compromise your information
How We May Use and Disclose Your Information
We may use or disclose your PHI for:
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Treatment: Providing, coordinating, or managing your healthcare
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Payment: Billing and payment activities
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Healthcare Operations: Quality assessment, staff training, administrative functions
Additional permitted uses include:
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Public health and safety requirements
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Legal or regulatory compliance
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Workers’ compensation claims
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Law enforcement or judicial proceedings when required by law
We will not use or disclose your PHI for marketing purposes or sell your information without your written authorization.
Your Rights
You have the right to:
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Request access to or copies of your medical records
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Request corrections to your medical record
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Request confidential communications
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Request restrictions on certain uses or disclosures
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Receive an accounting of disclosures
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Receive a paper copy of this Notice at any time
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File a complaint without fear of retaliation
Changes to This Notice
We reserve the right to change this Notice and make the new provisions effective for all PHI we maintain. Updated Notices will be available upon request and posted in our office and website.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with:
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SKINAESTHETICA INC., or
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The U.S. Department of Health & Human Services
You will not be retaliated against for filing a complaint.
Contact Information
Privacy Officers: Dr. Adriana Gonzalez, Dr. Michael Lipp
Practice: SKINAESTHETICA INC.
Phone: 909-547-3434

