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At Many Gates Healing Arts Center, we value you and respect your privacy and confidentiality of your health information.  We pledge our commitment to treating your information responsibly.  We restrict access to your health information with Many Gates to those staff who need to know in order to provide appropriate treatment and services to you and to conduct Many Gates' business on your behalf.

This Notice of Privacy Practices describes how we may use and disclose your medical/health information and how you can get access to this information.  This Notice applies to uses and disclosures we may make of all your health information whether created or received by us.

OUR COMMITMENT TO YOUR PRIVACY

We are required by law to maintain the privacy of your health information and to provide you with notice of our legal duties and privacy practices and comply with the terms of our notice that we have in effect currently.

We reserve the right to change our practices and to make the new provisions effective for all health information we maintain, including both health information we already have and health information we create or receive in the future.  Should we make material changes, we will make the revised notice available to you by posting it.

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

The following categories describe different ways that we may use and disclose your health information for purposes of treatment, payment and health care operations as described below.  Under the Privacy regulations, we may make the following uses and disclosures without obtaining a written authorization from you.

For Treatment: We may use and disclose your health information to provide you with treatment and services and to coordinate your care.  Your health information may be shared with psychotherapists, doctors, lab technicians, or other personnel involved in your care, both within Many Gates and with other health care providers involved in your care.  We may also disclose your health information to persons or facilities that will be involved in your care after you leave us.

For Payment: We may use and disclose your health information so that we can bill and receive payment for the treatment and services you receive.

To Persons Involved in Your Care or Payment for Your Care: We may disclose health information about you to a family member, close personal friend or other person you identify, including clergy, who is involved in your care.  These disclosures are limited to information relevant to the person's involvement in your care or in arranging payment for your care.

For Healthcare Operations: We may use and disclose your health information as necessary for our internal operations, such as for general administration activities and to monitor the quality of care you receive with us.

For Appointment Reminders: We may use or disclose health information to remind you about appointments.

For Treatment Alternatives and Health-Related Benefits and Services: We may use or disclose your health information to inform you about treatment alternatives and health-related benefits and services that may be of interest to you.

To Business Associates: We may disclose your health information to our business associates who perform various activities (e.g., collections transcription services, pharmacy) for our center.

For Health Oversight Activities: We may disclose your health information to a health oversight agency for activities authorized by law.  A health oversight agency is a state or federal agency that oversees the health care system.

For Reporting Victims of Abuse, Neglect or Domestic Violence: If we believe that you have been a victim of abuse, neglect or domestic violence, we may use and disclose your health information to notify a government authority, if authorized by law or if you agree to the report.

For Workers' Compensation and Disability: We may use or disclose your health information to comply with laws relating to workers' compensation or similar programs.

To Avert a Serious Threat to Health or Safety: When necessary to prevent a serious threat to your health or safety, or the health or safety of the public or another person, we may use or disclose your health information to someone able to help lessen or prevent the threatened harm.

For Court Orders and Judicial and Proceedings: We may disclose your health information in response to a court or administrative order when required by law to do so.  We also may disclose information in response to a subpoena, discovery request, or other lawful process.

For Other Law Enforcement Activities: We may disclose your health information for certain law enforcement purposes, including, for example, to file reports required by law or to report emergencies or suspicious deaths; to comply with a court order, warrant, or other legal process; to identify or locate a suspect or missing person; or to answer certain requests for information concerning crimes.

For Law Enforcement Custody of Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose your health information to the institution or official for certain purposes including your own health and safety as well as that of others.

For Military Purposes: If you are a member of the armed forces, we may use and disclose your health information as required by military command authorities.  We may also use and disclose health information about you if you are a member of a foreign military as required by the appropriate foreign military authority.

For National Security and Intelligence Activities: We may disclose health information to authorized federal officials conducting national security and intelligence activities or as needed to provide protection to the President of the United States, certain other persons or foreign heads of states or to conduct certain special investigations.

For Medical Emergencies: We may use or disclose health information in a medical emergency situation.

For Disaster Relief: We may disclose health information about you to an organization assisting in a disaster relief effort.

For Research: Your health information may be used for research purposes, but only if there is no identifiable client data, you have given written authorization for the use or disclosure, or the research occurs after your death.

On Behalf of Deceased Clients: We may disclose health information regarding deceased clients for the purpose of determining the cause of death, in connection with laws requiring the collection of death or other vital statistics, or permitting inquiry into the cause of death.

YOUR WRITTEN AUTHORIZATION IS REQUIRED FOR ALL OTHER
USES OR DISCLOSURES OF YOUR HEALTH INFORMATION

We will obtain your written authorization (an "Authorization") prior to making any use or disclosure other than those described above.  A written Authorization is designed to inform you of a specific use or disclosure, other than those set forth above, that we plan to make of your health information.  The Authorization describes the particular health information to be used or disclosed and the purpose of the use or disclosure.  Where applicable, the written Authorization will also specify the name of the person to whom we are disclosing the health information.

You may revoke a written Authorization previously given by you at any time but you must do so in writing.  If you revoke your Authorization, we will no longer use or disclose your health information for the purposes specified in that Authorization except where we have already taken actions in reliance on your Authorization.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the following rights regarding your health information:

Right to Request Restrictions: You have the right to request that we restrict the way we use or disclose your health information for treatment, payment or health care operations.  However, we are not required to agree to the restriction.

Right of Access to Your Personal Health Information: You have the right to inspect and, upon written request, obtain a copy of your health information except under certain limited circumstances.  We may deny your request to inspect or receive copies in certain limited circumstances.

Right to Request Amendment: You have the right to request that we amend your health information if you believe it is incorrect or incomplete.  Your request must be made in writing and must state the reason for the requested amendment.  We may deny your request for amendment if the information was not created by us, is not part of the health information maintained by us, or is already accurate and complete, as determined by us.

Right to an Accounting of Disclosures: You have the right to request an "accounting" of disclosures of your health information.  This is a listing of disclosures made by us or by others on our behalf, but does not include disclosures for treatment, payment and health care operations or certain other exceptions.

COMPLAINTS & QUESTIONS

If you believe that your privacy rights have been violated, you may file a complaint in writing with us.  If you have any questions regarding this notice or to file a complaint with us, please contact:

Privacy Officer
Many Gates Healing Arts Center
544 Riverside Avenue
Westport, CT 06880

 
   


"Until we accept the fact that life is founded in mystery we shall learn nothing." -- Henry Miller

 
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