The Company disseminates and maintains a Notice of Privacy Practices (“Privacy Notice” or “Notice”) that clearly states the manner in which it may use and disclose an individual’s protected health information (“PHI”), and provides adequate notice of an individual’s rights and Company’s legal duties with respect to PHI. Individuals have a right to request and receive a paper copy of the Privacy Notice at any time.
Each paper copy of the Privacy Notice given to an individual shall have attached to it a cover page entitled Patient Acknowledgement of Receipt of Notice of Privacy Practices, which the individual will be asked to date and sign at the time the individual is given the Privacy Notice. If the individual is unable or unwilling to date and sign the acknowledgement form, Company employees should document in writing on the face of the acknowledgement form the reason for the inability or refusal of the individual to sign. Such reason could simply be, e.g., that the individual refused to sign after being requested to do so. Company’s duty under the law is only to make a good faith effort to obtain the acknowledgement of receipt. If the individual does not want to sign the acknowledgement form, he or she is not required to do so.
If an individual wishes to receive the Notice electronically, the system should request the patient to acknowledge receipt electronically.
The Company will retain copies of the Privacy Notices issued by it for six (6) years following their last effective date, in accordance with Company’s record retention policy.
Clicking “I Agree” constitutes a legal signature and acknowledgment of this notice and verifies that I have read all of the information contained in this Notice of Privacy Practices.
