Dermatology Practice Privacy Policy

Introduction

At [Practice Name], we are committed to protecting your privacy and maintaining the confidentiality of your protected health information (PHI). This notice describes how medical information about you may be used and disclosed and how you can access this information.

Information We Collect

• Personal identification information
• Medical history and conditions
• Treatment records and photographs
• Insurance and payment information
• Communications with our practice

Use and Disclosure of Information

We May Use Your Information To:

• Provide and coordinate your dermatological care
• Obtain payment for services
• Conduct healthcare operations
• Contact you about appointments and treatment

Special Circumstances for Disclosure:

• Public health activities
• Health oversight activities
• Legal proceedings
• Law enforcement purposes
• Research (with proper authorization)

Your Rights

You have the right to:

1. Access your medical records
2. Request amendments to your information
3. Receive an accounting of disclosures
4. Request restrictions on certain uses
5. Choose confidential communication methods

Security Measures

• Electronic health records protection
• Staff training on privacy procedures
• Physical security of medical records
• Encrypted digital communications

Changes to Privacy Policy

We reserve the right to revise this policy. Any changes will be posted and made available to patients.

Contact Information

Privacy Officer: [Name] Phone: [Phone Number] Email: [Email Address]

Effective Date

This notice is effective as of [Date].

Acknowledgment

I acknowledge receipt of this Privacy Policy:

Signature: _________________ Date: _____________________