Privacy Policy | Advanced Metropolitan Dentistry
Notice of Privacy Practices
Effective February 26, 2005
This notice
describes how medical information about you may be used and disclosed, and how
you can access this information.
This Notice of Privacy Practices is provided to you as a requirement of
the Health Insurance Portability and Accountability Act (HIPAA). It describes
the limits to which we may use or disclose your protected health information,
with whom that information may be shared, and the safeguards we have in place
to protect it. This notice also describes your rights to access and amend your protected
health information. You have the right to approve or refuse the release of
specific information outside of our system, unless the release is required or
authorized by law or regulation.
Contact Us
For further
clarification of our Notice of Privacy Practices, you may send e-mail to
PrivacyOfficer@amddentistry.com or call (206) 464-9002. You may also write to:
Advanced
Metropolitan Dentistry
Privacy
Officer
1220
Howell St.
Suite
160
Seattle,
WA 98101
Additional
Resources
U.S.
Department of Health and Human Services
200 Independence Ave. SW
Washington, D.C. 20201
www.hhs.gov
Acknowledgment of Receipt of this Notice
Each patient is
asked to sign a consent form referencing this notice. Our intent is to make you
aware of the possible uses and disclosures of your protected health information
and your privacy rights. However, the delivery of your health care services
will in no way be contingent upon your signed acknowledgment. We will provide
you appropriate care whether or not you sign the form.
Who Will Follow This Notice
This notice describes Advanced Metropolitan Dentistry (AMD) practices
regarding your protected health information.
Our Duties to You Regarding Protected Health Information
"Protected
Health Information" is individually identifiable health information. This
information includes demographics, for example, age, address, e-mail address,
and relates to your past, present, or future physical or mental health or
condition and related health care services. Advanced Metropolitan Dentistry is
required by law to do the following:
• Make sure that your protected health information
is kept private.
• Give you this notice of our legal duties and privacy
practices related to the use and disclosure of your protected health
information.
• Follow the terms of the notice currently in effect.
• Communicate any changes in the notice to you.
We reserve the right to change this notice. Its effective date is at the top of the first page and at the bottom of the last page. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. If you would like a printed version of this notice, ask for a copy at your next hospital visit or clinic appointment, or click on the link below to download the document in its entirety.