Disclaimer & Privacy Notice
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Medical Disclaimer
The information provided on the web site of Infertility and Reproductive Medicine of South Broward is intended for informational purposes only and should not serve as a replacement for a medical consultation with a physician
Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. THE PRIVACY OF YOUR HEALTH INFORMATION IS IMPORTANT TO US.
Our
Legal Duty
We are required by applicable federal and state law to maintain the privacy
of your health information. We are also required to give you this Notice
about our privacy practices, our legal duties, and your rights concerning
your health information. We must follow the privacy practices that are
described in this Notice while it is in effect. This notice takes effect
on April 14th, 2003 and will remain in effect until we replace it.We reserve
the right to change our privacy practices and the terms of this Notice
at any time, provided such changes are permitted by applicable law. We
reserve the right to make the changes in our privacy practices and the
new terms on our Notice effective for all health information that we maintain,
including health information we created or received before we made the
changes. Before we make a significant change in our privacy practices,
we will change this Notice and make the new Notice available upon request.You may request
a copy of our Notice at any time. For more information about our privacy
practices, or for additional copies of this Notice, please contact us
using the information listed at the end of this Notice.Uses
and Disclosures of Health Information.
We use and disclose health information about you for treatment, payment
and healthcare operations; for example:Treatment. We may use or disclose your health information to a physician or other
healthcare provider providing treatment to you, laboratories, radiologists,
pharmacies, etc.Payment. We may use and disclose your health information to obtain payment for
services we provided to you.Healthcare
Operations. We may use and disclose your health information in connection
with our healthcare operations. Healthcare operations include quality
assessment and improvement activities, reviewing the competence or qualifications
of healthcare professionals, evaluating practitioner and provider performance,
conducting training programs, accreditation, certification, licensing
or credentialing activities.Organized
Health Care Arrangement. This facility and its medical staff
members have organized and are presenting this document to you as a joint
notice. Information will be shared as necessary to carry out treatment,
payment and health care operations. Physicians and other caregivers may
have access to protected health information here, or in their offices,
to assist in reviewing treatment (past or current) as it may affect treatment
at the time.Your
Authorization. In addition to our use of your health information
for treatment, payment or healthcare operations, you may give us written
authorization to use your health information or to disclose it to anyone
for any purpose. If you give us an authorization, you may revoke it in
writing at any time. Your revocation will not affect any use or disclosures
permitted by your authorization while it is in effect. Unless you give
us a written authorization, we cannot use or disclose your health information
for any reason except those described in this Notice.To
your Family and Friends. We must disclose your health information
to you, as described in the Patient Rights of this Notice. We may disclose
your health information to a family member, friend or any other person
to the extent necessary to help with your healthcare or with payment for
your healthcare, but only if you agree that we may do so. Persons
Involved in Care. We may use or disclose health information to
notify, or assist in the notification of (including identifying or locating)
a family member, your personal representative or another person responsible
for your care, of your location, your general condition, or death. If
you are present, then prior to use or disclosure of your health information,
we will provide you with an opportunity to object to such uses or disclosures.
In the event of your incapacity or emergency circumstances, we will disclose
health information based on a determination using our professional judgment
disclosing only health information that is directly relevant to the person’s
involvement in your healthcare. We will also use our professional judgment
and our experience with common practice to make reasonable inferences
of your best interest in allowing a person to pick up filled prescriptions,
medical supplies, x-rays or other similar forms of health information.Marketing
Health-Related Services. We will not use your health information
for marketing communications without your written authorization.Required
by Law. We may use or disclose your health information when we
are required to do so by law.Abuse
or Neglect. We may disclose your health information to appropriate
authorities if we reasonably believe that you are a possible victim of
abuse, neglect or domestic violence or the possible victim of other crimes.
We may disclose your health information to the extent necessary to avert
a serious threat to your health or safety or the health or safety of others.National
Security. We may disclose to military authorities the health
information of Armed Forces personnel under certain circumstances. We
may disclose to authorized federal officials health information required
by lawful intelligence, counterintelligence and other national security
activities. We may disclose to law enforcement officials having lawful
custody of protected health information of a patient under certain circumstances.Appointment
Reminders. We may use or disclose your health information to
provide you with appointment reminders (such as voicemail messages, postcards
or letters).
Patient RightsAccess. You have the right to look at or get copies of your health information, with limited exceptions. You must make a request in writing to obtain access to your health information. You may obtain a form to request access by using the contact information listed at the end of this Notice. You may also request access by sending us a letter to the address at the end of this Notice. We will charge you, as allowed by law, $1.00 for each of the first 25 pages and $0.25 for each additional page, and postage if you want the copies mailed to you.Disclosure Accounting. You have the right to receive a list of instances in which we or our business associates disclosed your health information for purposes, other than treatment, payment, healthcare operations and certain other activities, for the last six (6) years, but not before April 14th, 2003. If you request this accounting more than once in a twelve (12) month period, we may charge you a reasonable, cost-based fee for responding to these additional requests.Restriction. You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency).Alternative Communication. You have the right to request that we communicate with you about your health information by alternative means or to alternative locations. You must make your request in writing. Your request must specify the alternative means or location, and provide satisfactory explanation how payment will be handled under alternative means or location you request.
Electronic Notice. If you receive this Notice on our Website or by electronic mail (e-mail), you are entitled to receive this Notice in written form.
QUESTIONS AND COMPLAINTSIf you want more information about our privacy practices or have questions or concerns, please contact us.If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made about access to your health information or in response to a request you made to amend or restrict the use or disclosure of your health information or to have us communicate with you by alternative means or at alternative locations, you may complain to us by using the contact information listed at the end of this Notice. You also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon your request.We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.
Contact: Ana Lopez
Phone Number: 954-605-4391
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