This notice describes how information about you may be used and disclosed and how you can get access to this information. All medical information is handled pursuant to HIPAA standards.
Your Information
In this notice, when we use “your information” we are referring to information that identifies you and relates to your health. It includes the health and demographic information you provide.
Get a Copy of Your Information
You can request a copy of your referral packet or questionnaire. Call us at 800-383-3393 to ask how.
Ask Us To Correct Your Information
If you feel you have answered a question in error, or wish to provide additional information call us at 800-383-3393 to ask us how to correct an answer or provide additional information. You can also ask us to update your contact information.
Information Use and Sharing
The information you provide is used only by our doctors to provide an opinion on your ability to safely wear a respirator under the work conditions provided by your employer, or by select members of our staff to answer your questions when you call. The information you provide is not used for any other purpose, nor is it shared with any other person or entity unless a law requires us to share the information, or you request us to share it by signing Release of Medical Information form.
Effective Date: 5/1/2015
Changes to the Terms of this Notice:
We reserve the right to change the terms of this notice. Changes will apply to all information we have about you. Should changes occur, the new notice will be available upon request and on our website.