Acknowledgment of Review of Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
This practice uses and discloses health information about you for treatment, to obtain payment for treatment, for administrative purposes, and to evaluate the quality of care that you receive. The Health Insurance and Portability and Accountability Act (HIPAA) provides safeguards to protect your privacy. This document contains a condensed version of our policies.
This notice describes our privacy practices. We may change our policies and this notice at any time and have those revised policies apply to all the protected health information we maintain. If or when we change our notice, we will post the new notice in the office where it can be seen.
The following are the policies we have adopted, in brief:
Complaints: If you are concerned that your privacy rights have been violated, you may contact the person listed below. You may also send a written complaint to the U. S. Department of Health and Human Services. We will not retaliate against you for filing a complaint with us or the government.
Our Promise to You: We are required by law and regulation to protect the privacy of your medical information, to provide you with this notice of our privacy practices with respect to protected health information, and to abide by the terms of the notice of privacy practices in effect.
Questions and Contact Person for Requests: If you have any questions or want to make a request pursuant to the rights described above, please contact:
Dr. Huma Rashid
2860 S Alma School Road
Chandler, AZ 85286
This notice is effective January 1, 2021.