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Notice of Privacy Practices

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.

At Lafayette Foundation Clinic, we are committed to safeguarding your privacy and ensuring the confidentiality of your medical records and Protected Health Information (PHI). In accordance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable state laws, we maintain strict policies and procedures to protect your information.

 

Your Rights

You have the right to:

  • Get a copy of your medical record

  • Correct 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

 

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

  • Do research

  • Comply with the law

  • Respond to organ and tissue donation requests

  • Work with a medical examiner or funeral director

  • Address workers’ compensation, law enforcement, and other government requests

  • Respond to lawsuits and legal actions

 

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.

  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

  • We must follow the duties and privacy practices described in this notice and give you a copy of it.

  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time.

 

Changes to the Terms of This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.

 

 

Contact Information

If you have any questions about this notice, want to exercise your rights, or file a complaint, please contact:

Privacy Officer
Lafayette Foundation Clinic
117 Caillouet Place Lafayette LA 70501

Phone 337-988-9737 Fax 337-988-9739

You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

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