Geriatric Practice Privacy Policy

Introduction

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.

Our Commitment to Your Privacy

We understand that medical information about you and your health is personal. We are committed to protecting your medical information and following all applicable laws regarding the protection of your personal health information (PHI).

Your Rights

Regarding your medical records, you have the right to:

• Request restrictions on certain uses and disclosures
• Receive confidential communications
• Inspect and copy your health information
• Request amendments to your health information
• Receive an accounting of disclosures
• Obtain a paper copy of this notice

Special Considerations for Geriatric Patients

Authorized Representatives

• We recognize that many of our patients have designated family members or other individuals to help manage their healthcare
• Documentation of legal authority (Power of Attorney, etc.) must be provided
• Representatives have the same rights of access as patients

Use and Disclosure

We may use and disclose your medical information for:

1. Treatment
2. Payment
3. Healthcare operations
4. Research (with proper authorization)
5. Legal requirements

Security Measures

• Electronic health records are password protected
• Staff training on privacy procedures
• Regular security audits
• Secure disposal of records

Contact Information

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

Effective Date

This notice is effective as of [Date].

Signature

Patient/Representative

Date