Your Information. Your Rights. Our Responsibilities.

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.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities.

  • You can ask to see or get a copy of your medical record and other health information.
  • We will usually provide it within 30 days and may charge a reasonable fee.
  • You can ask us to correct your record. We may say no but will explain why in writing.

Request confidential communications

  • You can ask us to contact you in specific ways or at different addresses.
  • We will say yes to all reasonable requests.

Ask us to limit what we use or share

  • You can ask us not to use or share certain information. We may say no if it affects your care.
  • If you pay in full out-of-pocket, you can request we don’t share it with your insurer.
  • We’ll say yes unless a law requires us to share it.
  • You can request a list of those we’ve shared your info with over the past six years.

Get a copy of this privacy notice

  • You can ask for a paper copy anytime, even if you agreed to an electronic version.

Choose someone to act for you

  • If someone is your legal guardian or has medical power of attorney, they can act for you.
  • We’ll confirm their authority before taking action.

File a complaint if you feel your rights are violated

  • You can contact us or the U.S. Dept. of Health & Human Services at www.hhs.gov/ocr/privacy/hipaa/complaints/.
  • We won’t retaliate against you for filing a complaint.

Your Choices

You can tell us your choices about what we share in these situations:

  • With family, friends, or others involved in your care
  • In disaster relief situations
  • Include your info in a hospital directory
  • Contact you for fundraising

If you’re unable to tell us your preference, we may still share if it’s in your best interest or to reduce serious threats to health/safety.

We never share your information for marketing, sale of your data, or psychotherapy notes unless you give written permission.

Our Uses and Disclosures

Treat you

  • We use your info and share it with professionals treating you.

Example: A doctor consults another doctor about your condition.

Run our organization

  • We use/share your info to manage our practice and contact you when needed.

Example: We use health info to coordinate your care.

Bill for your services

  • We use/share your info to bill and get payment.

Example: We provide info to your health plan for coverage.

We may also use/share your info for public health, research, compliance with the law, and other permitted purposes. For full details, visit: HHS HIPAA page.

Help with public health and safety

  • Prevent disease
  • Product recalls
  • Report adverse medication reactions
  • Report abuse or violence
  • Prevent or reduce serious threats

Other permitted uses

  • Health research
  • Comply with legal obligations
  • Organ donation requests
  • Coroner/funeral director coordination
  • Workers’ comp and law enforcement needs
  • Government requests (military, national security, etc.)
  • Legal actions (court orders or subpoenas)

Our Responsibilities

  • We must protect your info under the law.
  • We’ll notify you if a breach occurs.
  • We follow this notice’s terms and will give you a copy.
  • We won’t share info beyond what’s outlined without written permission.

You can revoke consent at any time in writing.

Learn more: www.hhs.gov

Changes to This Notice

We may change this notice and apply changes to all information we maintain. Copies will be available online and upon request.

Effective Date: January 1, 2016

This privacy policy applies to:
Coastal Detox
1131 SE Indian Blvd
Stuart, FL 34997
Tel: 1-888-481-1993