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.

Central Florida Pain & Rehab Clinic is required to maintain the privacy of your protected health information and give you this notice of our legal duties and privacy practices regarding your health information.


USES AND DISCLOSURES OF YOUR HEALTH INFORMATION REQUIRING YOUR CONSENT: Central Florida Pain & Rehab Clinic will use and disclose your health information for the following purposes only with your written permission.

* TREATMENT: Central Florida Pain & Rehab Clinic may use and disclose your health information for your treatment and to provide you with treatment-related health care services. We may disclose all or any portion of your health information to physician(s), nurses, technicians, or other personnel, who are involved in your medical care and need the information to provide you with medical care.

* PAYMENT: Central Florida Pain & Rehab Clinic may use and disclose your health information for the purposes of billing and receiving payment from you, an insurance company, or a third party for the treatment and services you received. For example, we may give information to your health plan so that they will pay for your treatment.

* HEALTH CARE OPERATIONS: Central Florida Pain & Rehab Clinic may use and disclose your health information to evaluate and improve our medical care and to operate and manage our office. For example, we may use and disclose information to a peer review organization or a health plan that is evaluating our care. We may also share information with others that have a relationship with you for their health care operation activities.

* APPOINMENTS REMINDERS, TREATMENT ALTERNATIVES AND HEALTH-RELATED BENEFITS AND SERVICES: Central Florida Pain & Rehab Clinic may use and disclose your health information to contact you and remind you of your appointment, to tell you about treatment alternatives or health-related benefits and services you could use.

* INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR YOUR CARE: When appropriate, Central Florida Pain & Rehab Clinic may share your health information with a person involved in, or paying for, your care (such as your family or a close friend). We may notify your family about your location or condition or disclose such information to an entity assisting in disaster relief.

* BUSINESS ASSOCIATES: Central Florida Pain & Rehab Clinic may disclose your health information to our business associates that perform functions on our behalf or provide us with services if necessary. For example, we may use another company to perform billing services on our behalf. All of our business associates are obligated to protect the privacy of your information and are not allowed to use or disclose the information for any other purpose than appears in their contract with us.

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