Right to Request Additional Restrictions
- Right To Request Additional Restrictions. You have the right to request a restriction on how we use or disclose your health information to third parties for your medical treatment, payment of your medical claims, or management of our health care You also have the right to request a limitation on how we disclose your health information to those involved in your care or the payment for your care, such as a family member or friend. For instance, you can request that we not disclose information to your spouse or children concerning a sensitive surgical procedure or a disease you have suffered. Please note that under federal law, we are generally not required to agree to your request. However, if you pay the full cost of your treatment without any contribution from a health plan, your health care provider will agree upon your request not to share your treatment with your health plan for payment or health care operations purposes.
- Right To Request Confidential Communications. We communicate to you information about your health care treatment and If you feel that our communicating with you may endanger you, you may request that we communicate with you using a reasonable alternative means or location. For example, you can ask that we contact you only at work, by e-mail, or by mail at a specified address (such as a P.O. box, rather than your home mailing address). We will accommodate all reasonable requests.
- Right To A Paper Copy Of This Notice. You have the right to receive a paper copy of this You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice.
- or by writing to us at the address listed
- Right to Receive Notification of a Breach of Your Health You will receive timely notification if there is a breach of your unsecured health information.
CHANGES TO THIS NOTICE
We have the right to change the terms of this Notice. We also have the right to make these changes apply to health information we already have about you, as well as any we receive or create in the future. You can also come in our office and we can have a copy available at your request and take with you. Please look at the top right hand corner of the Notice to determine the Notice’s effective date
QUESTIONS OR COMPLAINTS
If you have questions about your privacy rights described in this Notice, or if you believe that we may have violated your privacy rights, please contact us at:
Gulfcoast Vascular Surgeons
8010 Summerlin Lakes Dr. Suite 100
Ft. Myers FL. 33912
You may also file a written complaint with us, as well as with the Department of Health and Human Services. We support your right to protect your health information. We will not penalize you or retaliate against you for filing a complaint.