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White Flint Medical & Natural Healing Center (WFMNHC) - 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.

WFMNHC is required by law to maintain the privacy of your health information and to provide you with notice its legal duties and privacy practices with respect to your health information. How WFMNHC may Use or Disclose Your Health Information

WFMNHC collects health information from you and stores it in a chart and on a computer. This is your medical record. The medical record is the property of WFMNHC, but the information in the medical record belongs to you. WFMNHC protects the privacy of your health information. The law permits WFMNHC to use or disclose your health information for the following purposes:

  1. Treatment.
  2. Payment.
  3. Regular Health Care Operations.
  4. Notification and communication with family. We may disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition or in the event of your death. If you are able and available to agree or object, we will give you the opportunity to object prior to making this notification. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.
  5. Required by law. As required by law, we may use and disclose your health information.
  6. Public health. As required by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability; reporting child abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure.
  7. Health oversight activities. We may disclose your health information to health agencies during the course of audits, investigations, inspections, licensure and other proceedings.
  8. Judicial and administrative proceedings. We may disclose your health information in the course of any administrative or judicial proceeding.
  9. Law enforcement. We may disclose your health information to a law enforcement official for purposes such as identifying of locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena and other law enforcement purposes.
  10. Deceased person information. We may disclose your health information to coroners, medical examiners and funeral directors.
  11. Worker's compensation. We may disclose your health information as necessary to comply with worker's compensation laws.

Name:______________________________________ Date:___________________________

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Maryland Chiropractor

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