Information You Provide Us
You can provide information to us on our website through various means, such as contacting us through our website or filling out forms electronically. Depending on which feature you are using, you may be asked to provide personal information such as, your name, address, telephone number or email address.
Information We Collect Automatically
We may collect and store information about your interaction with the Company. When you visit our website we use technologies, such as “cookies,” to determine whether or not you have visited our website before. A cookie is a small file containing a string of characters that is sent to your computer when you visit a website. The cookies we use do not collect any identifiable information from you, they are unable to execute any code or virus, and they cannot take any additional information from your hard drive. The cookies only allow our website to recognize your browser.
You can set your browser to notify you when you are sent a cookie, giving you the chance to decide whether or not to accept it. You can also reset your browser, or enable a private browsing mode, to refuse all cookies. However, some website features or services may not function properly without cookies.
How We Use Your Personal Information
We will not share the personal information we collect about you with any other entities for advertising or marketing purposes. However, we may share certain personal information with our affiliates to enhance their websites and services.
We may use or disclose your personal information to another party when we believe, in good faith, that access, use, preservation or disclosure of the information is reasonably necessary to meet an applicable law, regulation, subpoena, legal process or enforceable government request. We reserve the right to disclose your information when required to do so by law, or as needed to detect, prevent, or otherwise address fraud, security or technical issues.
Security of your Information
We take the security of your information very seriously. However, since the Internet is not a 100% secure environment, we cannot guarantee, ensure, or warrant the security of any information you transmit to us. There is no guarantee that information may not be accessed, disclosed, altered, or destroyed by breach of any of our physical, technical, or administrative safeguards.
Please note that emails you send to us through our website are not encrypted, and we strongly advise you not to communicate any confidential information through these means. In the event that there is a security breach of any of our users’ personal information, we will immediately notify users of such and will work quickly to cure the breach.
California Privacy Rights
Pursuant to California Civil Code Section 1798.83, California residents have the right to request from a business any personal information that a business may have shared with a third party for direct marketing purposes. To make such a request, please email us at: firstname.lastname@example.org.
The California Online Privacy Protection Act (CalOPPA) requires the Company to disclose how it responds to Do Not Track signals set in a user’s browser. We support Do Not Track browser settings. If you enable Do Not Track settings in the browser you are using, the Company will not store or use information about you other than your visit to the Company’s website.
Links To Other Sites
The content and services provided through the Company’s website is intended for a general audience. We do not knowingly collect, use, or disclose personal information from children under the age of 13 without prior parental consent, except as permitted by the Children’s Online Privacy Protection Act. If you are a parent who consents to the collection of personal information from your child, you agree that your child may use all of our services and that we may collect, use, and disclose your child’s personal information consistent with this Policy.
Changes to this Policy
We will occasionally update this privacy statement to reflect changes in our services and customer feedback. When we make changes to this privacy statement, we will revise the last updated date at the bottom of this statement.
Your Consent to This Policy
By using our website, you consent to this Policy. If you do not agree with this Policy, please do not use the Company’s website. We reserve the right to amend, modify or otherwise update this Policy at any time, so visitors are encouraged to review this Policy from time to time. Your continued use of the Company’s website following the posting of changes to these terms will mean your acceptance of those changes.
The following describes how medical information about you may be used and disclosed and how you can
get access to this information. Please review it carefully.
You have the right to:
• Get a copy of your paper or electronic medical record
• Correct your paper or electronic medical record
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated
You have some choices in the way that we use and share information as we:
• Tell family and friends about your condition
• Provide disaster relief
• Include you in a hospital directory
• Provide mental health care
• Market our services and sell your information
• Raise funds
Our Uses and Disclosures
We may use and share your information as we:
• Treat you
• Run our organization
• Bill for your services
• Help with public health and safety issues
• Do research
• Comply with the law
• Respond to organ and tissue donation requests
• Work with a medical examiner or funeral director
• Address workers’ compensation, law enforcement, and other government
• Respond to lawsuits and legal actions
When it comes to your health information, you have certain rights. This section explains your rights
and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
• You can ask to see or get an electronic or paper copy of your medical record and other health
information we have about you. Ask us how to do this.
• We will provide a copy or a summary of your health information, usually within 30 days of your
request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
• You can ask us to correct health information about you that you think is incorrect or incomplete.
Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
• You can ask us to contact you in a specific way (for example, home or office phone) or to send
mail to a different address.
• We will say “yes” to all reasonable requests.
Ask us to limit what we use or share
• You can ask us not to use or share certain health information for treatment, payment, or our
operations. We are not required to agree to your request, and we may say “no” if it would affect
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that
information for the purpose of payment or our operations with your health insurer. We will say
“yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
• You can ask for a list (accounting) of the times we’ve shared your health information for six
years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care
operations, and certain other disclosures (such as any you asked us to make). We’ll provide one
accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one
within 12 months.
Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice
electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
• If you have given someone medical power of attorney or if someone is your legal guardian, that
person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
• You can complain if you feel we have violated your rights by contacting us using the information
on page 1.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil
Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-
877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• We will not retaliate against you for filing a complaint.
For certain health information, you can tell us your choices about what we share. If you have a clear
preference for how we share your information in the situations described below, talk to us. Tell us what
you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation
• Include your information in a hospital directory
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead
and share your information if we believe it is in your best interest. We may also share your
information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes
In the case of fundraising:
• We may contact you for fundraising efforts, but you can tell us not to contact you again.
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization
We can use and share your health information to run our practice, improve your care, and contact
you when necessary.
Example: We use health information about you to manage your treatment and services.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other
Example: We give information about you to your health insurance plan so it will pay for your
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to
the public good, such as public health and research. We have to meet many conditions in the law before
we can share your information for these purposes. For more information see:
Help with public health and safety issues
We can share health information about you for certain situations such as:
• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety
We can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with the
Department of Health and Human Services if it wants to see that we’re complying with federal
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in
response to a subpoena.
• We are required by law to maintain the privacy and security of your protected health
• We will let you know promptly if a breach occurs that may have compromised the privacy or
security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of
• We will not use or share your information other than as described here unless you tell us we can
in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if
you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html .
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about
you. The new notice will be available upon request, in our office, and on our web site.
For questions or requests, email Ashley@theduckhousellc.com