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.

* WORKERS' COMPENSATION: Central Florida Pain & Rehab Clinic may release your health information for workers' compensation or similar programs that provide benefits for work-related injuries or illness.

* LAW ENFORCEMENT: Central Florida Pain & Rehab Clinic may release your health information request by law enforcement official if
1) there is a court order, subpoena, warrant, summons or similar process;
2) if the request is limited to information needed to identify or locate a suspect, fugitive, material witness, or missing person;
3) the information is about the victim of a crime even if, under certain very limited circumstances, we are unable to obtain your agreement;
4) the information is about a death that may be the result of criminal conduct;
5) the information is relevant to criminal conduct on our premises; and
6) it is needed in an emergency to report a crime, the location of a crime or victims, or the identity, description, or location of the person who may have committed the crime.

* CORONERS, MEDICAL EXAMINERS, AND FUNERAL DIRECTORS: Central Florida Pain & Rehab Clinic may release your health information to a coroner, medical examiner, or funeral director to identify a deceased person or cause of death, or other similar circumstance.

* NATIONAL SECURITY AND INTELLIGENCE ACTIVITIES: Central Florida Pain & Rehab Clinic may disclose your health information to authorized federal officials for intelligence and other national security activities authorized by law.

* INMATES OR INDIVIDUALS IN CUSTODY: If you are an inmate of a correctional institution or in custody, Central Florida Pain & Rehab Clinic may disclose your information
1) for the institution to provide you with health care,
2) to protect your health and safety or that of others, and
3) for the safety and security of the institution.

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