General Health Survey

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Notice of Privacy Practices - 4 minute read

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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.

KindHealth Assurance
KindHealth is committed to ensuring your health information is secure, and we protect your anonymity and privacy. We put physical, electronic and managerial procedures in place to safeguard and secure any data you provide us.

What is Protected Health Information?
Health information is any information about you, in any form that we either create, or receive from outside sources. This Notice of Privacy Practices refers to all health information as protected health information or “PHI”. Individually identifiable PHI includes health and demographic information collected from you which can reasonably be used to identify you.

PHI and the Law
Both state and federal law require KindHealth to limit the manner it uses or discloses information about a patient or a patient’s PHI in order to maintain your privacy. In addition, we are required to provide you with this privacy notice setting forth our legal duties and obligations, and your rights with respect to your PHI. All KindHealth care professionals and staff providing services in our practice are subject to this Notice of Privacy Practices and we may update the Notice from time to time, in which case we will prominently display the updated version.

Uses and Disclosures of Your PHI
This list is not all-inclusive. KindHealth uses any information you provide to us only in accordance with this Notice of Privacy Practices. KindHealth uses any information you provide to us only in accordance with this privacy statement. If you are an existing patient, you have already signed a consent. We will ask you to sign a consent if you are a new patient. The consent will allow KindHealth to use and disclose your PHI for your treatment, to obtain payment for the services we render to you and to assist us in our healthcare operations. We may use or disclose your PHI for your treatment or payments.

Treatments:
KindHealth may disclose and verify me as a patient to any law enforcement agency, my physician(s), Child Protective Services or any State approved dispensary.
Our medical records personnel may review your chart to ensure proper placement of all lab and other tests results in your chart prior to your visit.
Our medical staff or physicians may communicate with laboratory or other testing facilities to review test results prior to your visit.
KindHealth staff and doctors may discuss your case among themselves or review your medical treatment with referring physicians or physicians to whom they have referred you for care.
Personnel in this office may discuss your medical information with a hospital or other healthcare facility treating you or we may discuss this information with another healthcare provider who is treating you at such a facility.
This practice may announce the names of patients in the waiting area, and others may hear your name.
This practice may leave VMs on your home answering machine, or send postcard or email appointment reminders.
This practice may disclose health information to a dispensary when we order a prescription for you.
This practice may send you information about other health-related benefits and services that may be of interest to you.
Payment Delinquency:
This practice may provide consumer-reporting agencies with credit information regarding your payment history.
This practice may provide information to collection agencies, our attorneys, or in a legal action for purposes of obtaining payment of delinquent accounts.

A printed copy of this form is available on request. I understand that KindHealth reserves the right to make changes to the terms of its Notice of Privacy Practices. I have read and understood the above Notice of Privacy Practices.

KindHealth Clinic Patient Intake Form

General Health Survey

Fast. Easy. Care.

STOP HERE. This online application is only for those who have never previously been to our medical clinic. If you are already a patient, contact the receptionist, or call us at (786) 953-6838 for more information concerning your current healthcare needs.

NOTICE OF PRIVACY PRACTICES

KindHealth Assurance

What is Protected Health Information?

PHI and the Law

Uses and Disclosures of Your PHI

Treatments:

Payment Delinquency:

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SMS PRIVACY POLICY