NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW YOUR HEALTH AND MEDICAL INFORMATION MAY BE USED AND DISCLOSED, AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
At GameTime Men's Health Clinic, we understand that your health information is personal. Protecting your privacy is our priority. Federal and state laws require us to maintain the confidentiality of your health information and provide you with this Notice outlining our legal duties and privacy practices. We must follow the practices described in this Notice while it is in effect.
OUR RESPONSIBILITIES
We are committed to safeguarding your health information.
We will notify you promptly in case of a breach that may compromise your privacy or security.
We reserve the right to modify our privacy practices, as permitted by law, and will provide an updated Notice upon request.
USES AND DISCLOSURES OF HEALTH INFORMATION
We may use and disclose your health information in the following ways:
For Consultation
We may share your health information with a physician or healthcare provider consulting with you.
For Payment
Your health information may be used or disclosed to obtain payment for services provided to you.
For Healthcare Operations
We may use and disclose your health information for operational purposes such as evaluating provider performance, staff training, quality assessment, and compliance with regulations.
With Your Authorization
Beyond the uses above, we will not share your information without your written consent. You may revoke this authorization in writing at any time.
With Family and Friends
We may disclose relevant health information to family members or others involved in your care, but only with your consent.
In Case of Emergency
If you are incapacitated or in an emergency situation, we may use professional judgment to share only necessary information with individuals involved in your care.
For Marketing Purposes
We will not use your health information for marketing without your written permission.
As Required by Law
We may disclose your health information when required by state or federal law, including compliance audits by the Department of Health and Human Services.
For National Security & Legal Matters
Under certain circumstances, we may disclose health information to military authorities, federal officials, or law enforcement agencies.
Legal Proceedings
We may release your health information in response to a court order, subpoena, or legal request.
Appointment Reminders
We may contact you via phone, text, email, or mail regarding appointment reminders or health-related services.
YOUR RIGHTS
Access to Records
You have the right to request copies of your health information. Requests must be made in writing, and reasonable fees may apply for copying and mailing.
Requesting Restrictions
You may request additional restrictions on the use or disclosure of your information. We are not required to agree but will comply when possible.
Alternative Communication
You have the right to request alternative communication methods (e.g., mailing to a different address). Requests must be in writing and must specify how payment will be handled.
Amending Your Information
If you believe your records are inaccurate, you can request an amendment in writing. Requests must include a reason for the amendment. We may deny requests in certain circumstances.
Electronic Notice
If you receive this Notice electronically, you may request a paper copy at any time.
QUESTIONS & COMPLAINTS
If you have questions or concerns about your privacy rights, or if you believe we have violated your rights, you may contact us using the details below:
GameTime Men's Health Clinic
123 Wellness Blvd, Suite 200
Los Angeles, CA 90001
Email: info@gametimetrt.com
Phone: (800) 555-GAME
You also have the right to file a complaint with the U.S. Department of Health and Human Services by mailing 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 support your right to privacy and will not retaliate against you for filing a complaint.