For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have Share information with your family, close friends, or others involved both the right and in your care choice to tell us to: Share information in a disaster relief situation Include your information in a hospital directory Contact you for fundraising efforts If you are not able to tell us your preference, for example if you are unconscious, we may go and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. In these cases we Marketing purposes never share your Sale of your information information unless you give us written Most sharing of psychotherapy notes permission: In the case of fundraising: We may contact you for fundraising efforts, but you can tell us not to contact you again. Our Uses and Disclosures How do we typically use or share your health information? We typically use or share your health information in the following ways. Treat you We can use your health information Example: A doctor treating you and it with other professionals who for an injury asks another doctor are treating you. about your overall health condition. Run our We can use and share your health Example: We use health information to run our practice, improve organization information about you to manage your care, your treatment and services. and contact you when necessary. Bill for We can use and share your health Example: We give information your information to bill and get payment from you to your health insurance services health plans or other entities. plan so it will pay for your services. continued on next page
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to: Share information with your family, close friends, or others involved in your care Share information in a disaster relief situation Include your information in a hospital directory Contact you for fundraising efforts If you are not able to tell us your preference, for example if you are unconscious, we may go and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. In these cases we never share your information unless you give us written permission: Marketing purposes Sale of your information Most sharing of psychotherapy notes In the case of fundraising: We may contact you for fundraising efforts, but you can tell us not to contact you again. Our Uses and Disclosures How do we typically use or share your health information? We typically use or share your health information in the following ways. Treat you We can use your health information and it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition. Run our organization We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services. Bill for your services We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information you to your health insurance plan so it will pay for your services. continued on next page
tewksbury-privacy-practices.docx