This notice describes how medical information (as distinct from other non-medical personal or purchase information) about you may be used and disclosed and how you can access your medical information in the event that HIIP receives or possesses any such medical information. Please review this policy carefully. HIIP respects your privacy We understand that medical information is personal and we are committed to protecting that information. We create a record of the services you receive from HIIP and the information that you provide to HIIP in order to provide you with quality service and to comply with certain legal requirements. This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information. We endeavor to make sure that the medical information that identifies you is kept private. Please note that the fact of receiving services and your patronage of HIIP is not in and of itself medical information. Use of medical information For Support. In order to offer the best support during your program(s), we may need to give medical information to HIIP staff involved in providing your services or support. For Service Operations. We may use and disclose medical information about you for service operations that are necessary to make sure all of our members receive quality support. For example, we may use medical information to review our services and evaluate the performance of our staff in providing services to you. Appointment Reminders & Other Services. We may use and disclose your medical information to remind you about future appointments or to tell you about additional services that may be of interest to you. Other Individuals. In an emergency we may release medical information about you to a friend or family member. In addition, in the case of emergency we may disclose medical information about you to another physician or healthcare worker. We may disclose medical information about you to an entity assisting in a disaster relief effort. We may also disclose medical information about you as required by law or to maintain compliance with safety regulations. In all other cases, only upon receipt of the HIIP Health Information Release/Disclosure form with your signature and authorization will any information about you be released to an authorized party. Your rights regarding your medical information You can inspect and receive a copy of your medical information. You have the right to inspect and, for a nominal fee, receive a copy of your medical chart or history, if any. You can amend your medical information. If you feel that the medical information we have about you is incorrect or incomplete, you may amend the information or add comments to medical information about you. You can request restrictions on medical information. You have the right to request restriction or limit the medical information we use or disclose about you for services or service operations. You also have the right to request a limit on the medical information we disclose about you to others, like a family member. Right to request confidential communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by e-mail when communicating about medical issues. Changes to this statement A current copy of this notice will be available at any HIIP location or online. A copy will be sent to you if requested. We reserve the right to change the terms of this notice at the sole discretion of HIIP. Other uses of medical information Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. You may revoke that permission in writing at any time with the understanding that we are unable to take back any disclosures we have already made with your permission. Complaints Members may voice grievances and recommend changes in policies and services to facility staff or through the HIIP Privacy Officer at any time. Our goal is to provide quality services and to respond immediately to our member’s concerns. Thank you for reading this privacy statement. You may contact the Privacy Officer should you have any questions, concerns or need to act on any of the items you have read about. The Privacy Officer may be contacted at: HIIP Privacy Officer