Weld County Paramedic Services
Effective Date: April 14, 2003
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.
If you have any questions about this notice, please contact:
-
David W. Bressler
-
Privacy Officer.
-
970-353-5700 extension 3211.
Our Pledge Regarding Health Information:
We understand that health information about you and your health care is personal. We are committed to protecting health information about you. We create a record of the care and services you receive from us. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this health care practice, whether made by your personal doctor or others working in this office. This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights to the health information we keep about you, and describe certain obligations we have regarding the use and disclosure of your health information.
We are required by law to:
-
Make sure that health information that identifies you is kept private.
-
Give you this notice of our legal duties and privacy practices with respect to health information about you.
-
Follow the terms of the notice that is currently in effect.
Changes To This Notice:
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our facility. The notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you register for treatment or health care services, we will offer you a copy of the current notice in effect.
Complaints:
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services.
To file a complaint with us, contact David W. Bressler, Privacy Officer. All complaints must be submitted in writing.
You will not be penalized for filing a complaint.
Other Uses Of Health Information:
Other uses and disclosures of health information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
Acknowledgement Of Receipt Of This Notice:
We will request that you sign a separate form or notice acknowledging you have received a copy of this notice. If you choose, or are not able to sign, a staff member will sign their name, date.
This acknowledgement will be filed with your account record.