Notices of patient information practices

USES AND DISCLOSURES OF HEALTH INFORMATION

Once in a Lifetime treatments uses your personal health information primarily for treatment; obtaining payment for treatment; conducting internal administrative activities and evaluation for the quality of care that we provide.

For example, Once in a Lifetime treatments may use your personal information to contact you to provide appointment reminders, or information about treatment alternatives or other health related benefits that could be of interest to you.

Once in a Lifetime treatments may also use or disclose your personal health information without prior authorisation for public health purposes in the unlikely event of an emergency during a treatment for your benefit or otherwise required by law.

In any other situation, Once in a Lifetime treatments policy is to obtain your written authorisation before disclosing your personal health information. If you provide us with a written authorisation to release your information for any reason, you may later revoke that authorisation to stop future disclosures at any time.

Once in a Lifetime treatments may change its policy at any time. When changes are made, a new Notice of Patient Information Practices will be provided. You may also request an updated copy of our Notice of Patient Information Practices at any time.

Patients' Individual Rights

You have the right to review or obtain a copy of your personal health information at any time. You have the right to request that we correct any inaccurate or incomplete information in your records. You also have the right to request a list of instances where we have disclosed your personal health information for reasons other than treatment, payment or other related administrative purposes.

You may also request in writing that we not use or disclose your personal health information for treatment, payment and administrative purposes except when specifically authorised by you, when required by law or in emergency circumstances. Once in a Lifetime treatments will consider all such requests on a case by case basis, but Once in a Lifetime treatments is not legally required to accept them.

Concerns and Complaints

If you are concerned that Once in a Lifetime treatments may have violated your privacy rights or if you disagree with any decision we have made regarding access or disclosure of your personal information, please contact us.

Patient Information Consent Form

I have read and fully understand Once in a Lifetime treatments Notice of Patient Information Practices. I understand that Once in a Lifetime treatments may use or disclose my personal health information for the purposes of carrying out treatment, obtaining payment, evaluating the quality of services provided and any administrative operations related to treatment or payment.

I understand that I have the right to restrict how my personal health information is used and disclosed for treatment, payment and administrative operations if I notify the manager. I also understand that Once in a Lifetime treatments will consider requests for restriction on a case by case basis, but does not have to agree to requests for restrictions.

I hereby consent to the use and disclosure of my personal health information for purposes as noted in Once in a Lifetime treatments Notice of Patient Information Practices. I understand that I retain the right to revoke this consent by notifying the manager in writing at any time.

Signature

Client Name (PRINT)

Date

Head Toe To Beauty -The UK's Leading directory of fitness, beauty, health and spiritual professionals, source your professional now, hundreds of profiles to view online now! Join us if you are a professional from just £19.99 for 365 days! Visit us today.

Ebooks!