Your Privacy


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 7/6/2011, 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 of our Notice effective for all 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 and healthcare operations. For example (these examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office):

Treatment: We may use or disclose your personal health information to a physician or other healthcare providers providing treatment to you.

Healthcare Operations: We may use and disclose your health information in connection with our healthcare operations including quality assessment and improvement activities.

Your Authorization: In addition, 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 was 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 section of this Notice. We may disclose your health information to a family member, friend or other person to the extent necessary to help with your healthcare, but only if you agree in writing 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 copies of your health information.

Marketing Health-Related Services: We do not use your health information for marketing communications without your written authorization. Required by Law: We may use or disclose your health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), or in certain conditions in response to a subpoena, discovery request or other lawful process. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, if required by law, of any such uses or disclosures.

Coroners, Funeral Directors, and Organ Donation: We may disclose protected health information to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose such information in reasonable anticipation of death.

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, 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 correctional institution or law enforcement official having lawful custody of protected health information of inmate or patient under certain circumstances.

Appointment Reminders: We may use or disclose your personal health information to provide you with appointment reminders (such as: voicemail, messages, postcards, letters, or other mailings).


Access: You have the right to copy and inspect your health information with limited expectations. You may request that we provide you with copies, as long as we receive your request in writing, and we may ask for a copy of your state photo ID. You may obtain a form to request access by contacting the office. We will charge a reasonable fee, as per Oregon law (ORS 192.521).

Restrictions: 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).

Amendment: You have the right to request that we amend your health information (request must be made in writing) and it must explain why the information should be amended. We may deny your request under certain circumstances.

Disclosure Accounting/Communication Barriers: It is the policy of ACC to always attempt to contact you if we are releasing your health care information. We will also always attempt to contact you to inform you of any health information requests for disclosure (with or without your signed permission). It is important to always keep The AC Clinics updated on your current phone number or contact information.

Questions or Concerns: Please don't hesitate to contact us.

Complaints: If feel that your rights have been violated, please contact the US Department of Health and Human Services. 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 US Department of Health and Human Services.