Effective date: [Insert date]. 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.
Your rights
You have the right to access, obtain a copy of, and request corrections to your health information; request confidential communications; ask us to limit what we share; obtain a list of disclosures; and receive a paper or electronic copy of this notice.
Our uses and disclosures
We typically use or share your health information to treat you, run our organization, and bill for services. We may also share information for public health and safety, research, compliance with the law, organ and tissue donation, workers' compensation, law enforcement, and other government requests as permitted by HIPAA.
Our responsibilities
We are required by law to maintain the privacy and security of your protected health information (PHI), notify you following a breach of unsecured PHI, and follow the duties and privacy practices described in this notice.
This is a summary. Replace this content with your full, practice-specific Notice of Privacy Practices to meet HIPAA requirements. Consult your counsel or compliance advisor.