Schedule an Appointment: 850-407-7840

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.

IV. Special Situations In Which Your Health Information May Be Released
Your health care information may be released in the following special situations:

  • Public Health Risks: As authorized by law, we may disclose health information about you to public health or legal authorities whose official responsibilities generally include the following:

    • to prevent or control disease, injury or disability;
    • to report births and deaths;
    • to report child abuse or neglect;
    • to report reactions to medications or problems with products;
    • to notify people of recalls of products they may be using;
    • to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and
    • to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
  • Organ and Tissue Donation: Consistent with applicable law, we may release your health information to organ procurement organizations or others engaged in the transplantation of organs to enable a possible transplant, if authorized by you, or provided for by law.

  • Specialized Government Functions: If you are a member of the military or a veteran, we will disclose health information about you as required by command authorities; or if you give us your written permission. We may also disclose your health information for other specialized government functions such as national security or intelligence activities.

  • Workers' Compensation: If you are seeking compensation due to a work-related injury, we may release health information about you to the extent necessary to comply with laws relating to Workers Compensation claims.

  • Employers: We may release health information to your employer if we provide health treatment to you at the request of your employer, and the health care services are provided either to conduct an evaluation relating to medical surveillance of the workplace or to evaluate whether you have a work-related illness or injury. In such circumstances, we will provide you with written notice of such information disclosure. Any other disclosures to your employer will be made only if you sign a specific authorization for the release of that information.

  • Health Oversight Activities: We must disclose health information to a health oversight agency for activities that are required by federal, state or local law. Oversight activities include investigations, inspections, industry licensures, and government audits. These activities are necessary to enable government agencies to monitor various health care systems, government programs, and industry compliance with civil rights laws. Most states require that identifying information about you, such as your social security number, be removed from information

  • Lawsuits and Disputes: If you are involved in a lawsuit, dispute, or other judicial proceeding, we may disclose health information about you in response to a court order or subpoena, or other lawful process.

  • Law Enforcement: We may disclose your health information to a law enforcement official if required or allowed by law, such as for gunshot wounds and some burns. We may also disclose information about you to law enforcement that is not a part of your health record for the following reasons:

    • to identify or locate a suspect, fugitive, material witness, victim of a crime, or missing person;
    • about a death we believe may be the result of criminal conduct;
    • about criminal conduct at our location; and
    • in emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
  • Correctional Facilities: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose health information about you to the correctional institution or law enforcement official only as required by law or with your written permission. We may release your health information for your health and safety, for the health and safety of others, or for the safety and security of the correctional institution.

  • Coroners, Medical Examiners, and Funeral Directors: We may disclose certain health information about you to a coroner or medical examiner in the case of certain types of death. This may be necessary, for example, to make a positive identification of you or to determine the cause of your death. We may also release the fact of death and certain demographic information about you to funeral directors as needed to carry out their duties. Other releases of your health information will require the written permission of a surviving spouse, parent, a person appointed by you in writing, or your legally authorized representative.

  • Required by HIPAA Law: The Secretary of the Department of Health and Human Services (HHS) may investigate privacy violations. If your health information is requested as part of an investigation, we must share your information with the HHS.

< PAGE ONE | PAGE THREE >