## X. EXHIBITS 

HIPAA gives you certain rights with respect to your PHI. You have the right to: 

• Ask us to communicate with you in a certain way or at a certain location. We will accommodate reasonable requests. 

• Request that we restrict the way we use or disclose your PHI in connection with health care operations, payment and treatment. We will consider, but may not agree to, such requests. You also have the right to ask us to restrict disclosures to persons involved in your health care. 

• Obtain a copy of certain portions of your PHI, subject to applicable federal, state and local laws, rules and regulations. We may ask you to make your request in writing, may charge a reasonable fee for producing and mailing the copies, and in certain cases may deny the request. 

• Amend PHI that you believe to be incorrect. Your request must be in writing and must include the reason for the request. If we deny the request, you may file a written statement of disagreement. 

• Have us provide you with a list of certain disclosures of PHI we have made about you. Your request must be in writing. If you request such an account - ing more than once in a twelve month period, we may charge a reasonable fee. 

• File a complaint if you think your privacy rights have been violated. You will not be penalized or retaliated against for filing a complaint. To file a com - plaint, you must contact the United States Department of Health and Human Services, Office of Civil Rights. For more information about how to file a complaint, please visit www.hhs.gov/ocr/hipaa. 

By signing the Player’s Consent and Agreement to the ATP Official Rulebook, you acknowledge that any health information that is disclosed in accordance with this authorization form might be redisclosed by the recipient of that information and may no longer be protected by federal health care privacy laws and rules. 

If you have questions regarding your PHI, confidentiality of your PHI, or this No - tice, please contact: 

ATP Tour, Inc. Attn: Player Relations Departmen t 201 ATP Tour Blvd Ponte Vedra Beach, Florida 32082 

## GENERAL PRIVACY CONSIDERATIONS RELATING TO PHYSIOTHERAPIST ROOMS AND TREATMENT ROOMS 

This notice also is intended to remind you that the ATP Physiotherapist and/or Treatment Rooms provided at the Tournaments are not designated as a private area. Should you choose to receive treatment there, or discuss confidential infor - mation (health or otherwise), it is possible that this information may be overheard by individuals that have no obligation to refrain from further disclosure of such information. Access to these areas is not limited to ATP personnel. Players are reminded of their duties and obligations arising from the ATP Rules and Anti-Co - ercion Policy. The information discussed, as well as photographic images also may be intercepted by electronic surveillance devices including but not limited to 

## YOUR LEGAL RIGHTS REGARDING PHI 

## X. EXHIBITS 

digital and other cameras, video cameras, cellular telephones and personal data devices. Neither the Tournament nor ATP is responsible for the unauthorized capturing of any PHI or other personal/confidential information or the subsequent disclosure of the same. 

Should you wish to ensure the confidential nature of health or other information, we encourage you to receive treatment in a secure environment of your choosing. 

