BRANDON MENTAL HEALTH
NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY USED AND DISCLOSED AND HOW YOU MAY GET ACCESS TO THIS INFORMATION
YOUR HEALTH INFORMATION RIGHTS
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
- You can ask to see or get a copy of your health record, however the Health Information Portability and Accountability Act (HIPAA) contains an exception for psychotherapy records and we may say “no” to your request.
- You can ask us to correct health information about you that you think is incorrect or incomplete.
- You can ask us to contact you in a specific way (for example, home or cell phone). We will say “yes” to all reasonable requests.
- You can request a list of disclosures we have made of your health information. The list may not include disclosures authorized by you, disclosures for treatment, payment and health care operations, and certain other disclosures.
- You can ask that we limit the use and disclosure of your health information. We are not required to agree to your request.
- You can ask for a paper copy of this notice at any time.
OUR RESPONSIBILITIES
- We can share health information about you in response to a court order, or in response to a subpoena.
- 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 upon request.
- We will not use or share your information other than described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
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.
FILING A COMPLAINT
If you believe your privacy rights have been violated by BMH or one of its staff, you may file a complaint with BMH and/or the Department of Health and Human Services at the addresses below. You will not be retaliated against for filing a complaint.
Brandon Mental Health, LLC Department of Health and Humans Services
1134 Bell Shoals Rd 200 Independence Ave, SW
Brandon, FL 33511 Washington, D.C. 20201
(813) 315-8648 (877) 696-6675