Notice of Privacy Practices for Endocrinology Practice

[Practice Name] Endocrinology

Effective Date: [Date]

Your Information. Your Rights. Our Responsibilities.

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.

Your Rights

You have the right to:

• Get a copy of your paper or electronic medical record
• Request corrections to your medical record
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we've shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated

Your Choices

You have choices regarding how we use and share information when we:

• Tell family and friends about your condition
• Include you in our patient directory
• Provide disaster relief
• Provide mental health care services
• Market our services
• Raise funds

Our Uses and Disclosures

We may use and share your information as we:

• Treat you
• Run our organization
• Bill for your services
• Help with public health and safety issues
• Conduct research
• Comply with the law
• Respond to organ and tissue donation requests
• Work with medical examiners or funeral directors
• Address workers' compensation, law enforcement, and other government requests

Specific to Endocrinology

We maintain particular confidentiality for:

• Hormone therapy records
• Genetic testing results
• Diabetes management data
• Weight management information
• Thyroid condition documentation

For More Information

Contact our Privacy Officer: [Name] [Phone] [Email] [Address]