Privacy Policy

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.

Uses and Disclosures

Treatment: Your protected health information (PHI) may be used by staff members to disclose to other healthcare professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For example, we may consult with your primary care physician regarding your case.

Payment: Your PHI may be used to seek payment for services provided to you. For example, we may send a report of progress to your insurance company.

Health Care Operations: Your PHI may be used as necessary for normal healthcare operations. For example, your address will be stored on our computer, and we may contact you via your address or telephone number.

Law Enforcement: Your PHI may be disclosed when required by law.

Other Uses and Disclosures: Except as above, your PHI will be made available only with your consent, authorization, or opportunity to object, unless required by law. If you change your mind after authorizing a use or disclosure of your PHI you may submit a written revocation of that authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision to revoke your authorization.

Your Rights

You have certain rights under federal privacy standards. These include:

  • The right to inspect and copy your PHI

  • The right to request a restriction on the use and disclosure of your PHI

  • The right to receive confidential communications concerning your medical condition and treatment

  • The right to amend or submit corrections to your PHI

  • The right to receive an account of how and to whom your PHI has been disclosed

  • The right to receive a printed copy of this notice

Roots to Blooms Acupuncture & Wellness, LLC Duties

We are required by law to maintain the privacy of your PHI and to provide you with this notice of privacy practices. We are also required to abide by the privacy policies and practices that are outlined in this notice. As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Upon request, we will provide you with the most recently revised notice on any office visit. The revised policies and practices will be applied to all PHI we maintain.

Complaints

If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to:

Privacy Officer/Administrator
Roots to Blooms Acupuncture & Wellness, LLC
921 Park Drive, Suite D
Lake Geneva, WI 53147

Effective Date

This notice is effective on or after 1 May, 2020