Notice of Privacy Practices
We use and disclose health information for many different reasons. For some of these uses or disclosures, we need your specific authorization. Below, we describe the different categories of uses and disclosures.
We may use and disclose your PHI without your authorization for the following reasons:
You have the following rights with respect to your PHI:
If you think that we may have violated your privacy rights, or you disagree with a decision we made about access to your PHI, you may file a complaint with the person listed in Section VI below. You may also send a written complaint to the Secretary of the Department of Health and Human Services at 200 Independence Avenue, S.W., Room 615F, Washington, D.C. 20201. We will take no retaliatory action against you if you file a complaint about our privacy practices.
If you have any questions about this notice or any complaints about our privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact: Privacy Officer, c/o Beverly Friedlander, M.D., 636 Morris Turnpike, Suite 2G, Short Hills, N.J. 07078, 973-912-9120, 973-912-8070 via fax, e-mail: firstname.lastname@example.org.
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