Notice of Privacy Practices

This note describes how medical information about you can be used and how to get access to this information. Please read carefully. Your medical record is protected under HIPAA federal law. There are limitations upon to whom and under what circumstances your medical information can be disclosed. We do not share your private medical information with your spouse, parent, or employer unless you request it or unless required by law. The law allows us to share your medical information with your insurance company in order to verify eligibility and that payment is appropriate for the visit. They may also review your record to ensure that we meet quality standards. We share information with other providers who are treating you or who referred you to us for consultation or treatment. We also provide information about your care and diagnosis when we request testing at a hospital, such as x-rays or laboratory testing. These other providers are also required to protect the confidentiality of your health information under HIPAA. We may consult you by mail or leave a general message, but we will not give your test results or other private information to a family member without your permission. We are not affiliated with any drug companies or other marketing services and will not release your health information to anyone for the purpose of marketing services to you. We may, however send you a reminder of an upcoming appointment. We may disclose information to the FDA in the event of an adverse drug reaction of, as required by law, to the department of Public Health in the event of certain communicable diseases. You may review your medical records or obtain a copy of it upon request. There is a charge for copying depending on the number of pages involved. HIPAA also allows you to make additions or corrections to your medical records. If you have questions about our policy of protecting your private medical record, you may discuss them with our privacy officer. We will copy and send your record to another doctor if you request. We do not Fax your medical records (unless it is deemed by us to be a medical emergency). It is often more efficient if you hand- carry the copy yourself in order to ensure that it arrives on time, into the right hands.

I have read the above Privacy Practices. Signature/Date

Notice of Privacy Practices

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30 Aldrin Road, Plymouth MA 508-746-8977

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104 Park Street, Hyannis MA 508-746-8977

544 Main Street, Weymouth MA 508-746-8977