We are required by federal and state law to maintain the privacy of your health information and to inform you of our practices in accomplishing this. Medial information about your past, current and future health is considered "Protected Health Information' ("PHI") and we understand this information is personal and we are committed to protecting this medical information about you. We are required by law to make sure your PHI is kept private and to provide you with this Notice detailing out legal duties and privacy practices, that explains how, when, and why we may use or disclose your PHI. This notice becomes effective April 14, 2003 and remains in effect until we replace it.

We reserve the right to change our privacy practices at any time. If we change our practices, we will post this changed Notice in the folders in the patient waiting areas. The notice will also be posted on our website at www.avonpodiatry.com. Any new change to our Notice will affect information we have created and also information we have received before we made the changes.

We will use and disclose your protected health information for your treatment, payment, and health care operations. This will not require your authorization. There are some uses/disclosures, which will require your authorization.

Treatment: We may disclose your PHI to provide, coordinate or manage your health care and any related services. This includes coordination and management of your health care with a third party, for example, a Home Health Care Agency. We will also disclose PHI to other physicians who may be treating you, for example, a physician who you have been referred to or from. We will also disclose your PHI to another physician who may become involved in your care (e.g., a specialist or laboratory or Xray facility), who, at the request of us becomes involved in your care.

Payment: We may use/disclose your PHI in order to bill and collect payment for your health care services. This may include activities your health care plan may undertake before it approves or pays for the health care services we recommend for you such as: predetermination of eligibility for coverage, reviewing services provided to you to ensure necessity.

For Health Care Operations: We may use or disclose, as needed, your PHI in order to conduct certain business and operational activities. These activities include, but are not limited to, quality assessment, employee review activities, training of students, licensing, and conducting or arranging other business activities.

For example, we may use a patient sign up sheet at the front reception desk, and we may call you by name in the reception room when the doctor is ready to see you. We may use or disclose your PHI when necessary to contact you by telephone or e-mail to remind you of an appointment or to relay normal lab results to you.

We will share your PHI with third party business associates that perform certain duties (e.g. billing or transcription services) We will keep a written contract with all our business associates that contains terms that protects your PHI.

We may use or disclose your PHI as necessary, to provide you with information about possible treatment alternatives or health related benefits and services that may be of interest to you. We may disclose your PHI for other marketing activities. For example, we may amyl you with a new service we feel is appropriate to your medical condition, or use your name on a mailing label to send you a newsletter about our services and practice. You may contact us to request these materials not be sent to you.

Uses and Disclosures Based on Your Written Authorization: Other disclosures of your PHI will be made only with your written authorization, unless otherwise permitted or required by law as described below.

You may give us your written authorization to use or disclose your PHI to anyone for any purpose, and you may revoke that authorization at any time. Any revocation will not affect any use or disclosure made while the authorization was in effect.

Others involved in your health care: Unless you object, we may disclose PHI to a family member, relative or close friend or any other person you identify as that PHI discloses relates to that persons involvement in your health care.

Marketing: We may use your PHI to contact you with information about possible treatments or alternatives we feel may be of interest or appropriate for you or of interest to you. Unless the information is in the form of a general newsletter, you may opt out by written request.

Research, Death, Organ Donation: We may use or disclose your PHI information for research purposes in limited circumstances. We may release PHI of a deceased person to a coroner, protected health examiner, funeral director or organ procurement organization for certain purposes.

Public Health or Safety: We may disclose your PHI to the extent necessary to avert a serious and imminent threat to your health or safety or the health or safety of others. We may disclose your PHI to a government agency when required to do so.

Abuse or neglect: We may disclose PHI to a public health authority authorized by law to receive reports of child abuse, elder abuse, or other abuse and we may disclose PHI to an authority if we feel you are a subject of abuse, neglect or domestic violence. The disclosure will be made consistent with the requirements of federal and state laws.

Food and Drug Administration: We may disclose your PHI to the FDA or a person or company required by the FDA to report adverse events, product defects or problems, biological product deviations, to track products, to enable product recalls, to conduct post marketing surveillance as required.

Criminal Activity, law enforcement: Consistent with applicable federal and state laws, we may disclose your PHI if we believe that the disclosure is necessary to prevent or lessen a serious and imminent threat to the health and safety of a person or the public of if that disclosure of PHI is necessary for law enforcement authorities to identify and or apprehend an individual. We may disclose PHI to a law enforcement authority for a suspected fugitive, material witness, crime victim or missing person.

Process and proceedings: We may disclose your PHI in response to a court or administrative order, subpoena, discovery request or other lawful process under certain circumstances. We may also, under limited circumstances, such as court order, warrant or grand jury subpoena, disclose your PHI to law enforcement officials.

Access: You have the right to look at or get copies of your PHI, with limited exceptions. You must make a request in writing to the contact person listed at the end of this document. We will respond to your request within 30 days. We may deny your request. If so, we will give you a written explanation why your request has been denied and explain any right you have to an appeal. You may also send your request to the address at the end of this Notice. If you request copies we will charge 15 cents per page and $20 per hour for staff time to locate and copy you PHI, and postage if you wish the copies mailed. If you prefer, we will prepare a summary or an explanation of your PHI for a fee. This fee will be $60 an hour to cover research, dictation, and transcription. Postage will be added in if you wish the summary mailed.

Disclosure Accounting: You have the right to receive a list or accounting of disclosures we have made of your PHI for purposes other than treatment, payment, health care operation and certain activities after April 14th, 2003. Your request can relate to disclosures going back as far as six years. This request will not include any disclosures made before April 14, 2003. Your request must be in writing. We will respond to your written request for such a list within 60 days of receiving it. There will be no charge for the first list requested each year, there will be a charge for subsequent copies at the fee of $20 per hour for each request as long as it does not require more than 1 hour to compile. Otherwise, the charge will be an additional $$20.

Restriction Requests: You have the right to request we limit or restrict how we use or disclose your PHI. You must make your request in writing. We will consider your request but are not obligated to agree to your restrictions. But if we do we will put the request in writing and abide by it except in emergency situations. You understand we cannot take back disclosures already made. We cannot agree to limit disclosures that are required by law. Any agreement we may make to a request for additional restrictions must be in writing signed by a person authorized to make such an agreement on our behalf. We will not be bound otherwise to any agreement.

Confidential Communication: You have the right to request that we send you information and or communicate with you at an alternative location or by alternate means. For example, you may request that we communicate with you only at work. You must make your request in writing. We must agree and accommodate you request as long as it is reasonable for us to do so, specifies the alternative means or location, and continues to permit us to bill and collect payment from you.

Amendment: If you believe there is a mistake or missing information in our record of your PHI, you have a right to request, in writing, that it be amended with a correction or addition. Your request must be in writing, and it must explain or support your reason for requesting the amendment. We must respond to your request with our decision within 60 days. We may deny your request for amendments if we determine the PHI is (1) correct and complete (2) not created by us or not part of our records, or (3) not permitted to be disclosed. If we deny your request, we will provide you with a written explanation. Any denial will also explain your rights to have the request and denial reviewed. You may respond with a statement of disagreement to be appended to the information you wanted amended. If we accept your request to amend the information, we will make reasonable efforts to inform others, including people or entities you name, of the amendments and to include the changes in any future disclosures of that information.

Electronic Notice: If you receive this notice on our website or by electronic mail (e-mail), you are entitled to receive this notice in written form. Please contact us using the information listed at the end of this notice to obtain this notice in written form.

Questions and complaints: If you have questions about this Notice or any complaints about our privacy practices, or disagree with a decision we made about access to your PHI or in response to a request you made, you may complain to us using the contact information below. You may also submit a written complaint to the US Department of Health and Human Services. We will provide you with the address to file your complaint with the US Department of Health and Human Services upon request.