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  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:

1. Treatment: We are permitted to use          and disclose your medical information to those involved in your          treatment.
2. Payment: We are permitted to          use and disclose your medical information to bill and collect payment          for the services we provide to you.
3. Health Care Operations: We          are permitted to use or disclose your medical information for the          purposes of health care operations, which are activities that support          this practice and ensure that quality care is delivered.
4. Disclosures That Can Be          Made Without Your Authorization: There are situations in which we are          permitted to disclose or use your medical information without your          written authorization or an opportunity to object. In other          situations, we will ask for your written authorization before using or          disclosing any identifiable health information about you. If you          choose to sign an authorization to disclose information, you can later          revoke that authorization, in writing, to stop future uses and          disclosures. However, any revocation will not apply to disclosures or          uses already made or that rely on that authorization. The following          are situations where we may disclose your medical information without          your authorization:
   1. Public Health, Abuse or           Neglect, and Health Oversight
   2. Legal Proceedings and Law           Enforcement
   3. Research, Organ Donation,           Coroners, Medical Examiners, and Funeral Directors
   4. Those instances required           by law
5. Your Rights under Federal          Law: The U. S. Department          of Health and Human Services created regulations intended to protect          patient privacy as required by the Health Insurance Portability and          Accountability Act (HIPAA). Those regulations create several          privileges that patients may exercise. We will not retaliate against          patients who exercise their HIPAA rights. Those rights are s follows
   1. You may request that we restrict           how your protected medical information is used. We, however, do not           need to agree to this restriction
   2. You may request that we           send your protected health information by alternative means or to an           alternative location.
   3. You may inspect and/or           copy your health information within a designated record set; request           must be in writing. There are limitations regarding the information           you may inspect or copy. Texas law requires us to release this           information within 15 days or your written request received by our           office. We will inform you if access has been denied or limited.           HIPAA permits us to charge a reasonable cost-based fee for such           information.
   4. You may request and           amendment of your medical information, however, we are not required           to do so.
   5. You may request an           accounting of certain disclosures that are for means other than for           treatment, payment, health care operations, or made via an           authorization signed by you or your representative.
6. Appointment Reminders,          Treatment Alternatives, and Other Benefits: we may contact you by   telephone, text message, mail, email to provide appointment reminders, information          about treatment alternatives, or other health-related benefits and          services that may be of interest to you. 
7. Your personal information will not be shared or sold to any third party for purpose of marketing
8. No mobile information will be shared with third parties/affiliates for marketing/promotional purpuses.

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

Ste 33

Chandler, AZ 85286

Phone: 4805811200

 Fax: 4805811300
 

This notice is effective January 1, 2021.