Nutrition Privacy Policy

5 Bridges Health and Fitness, 4450 Oakhurst Blvd, Harrisburg PA 17110, (717)-412-0507

NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE
REVIEW IT CAREFULLY.

I. OUR PLEDGE REGARDING HEALTH INFORMATION:
Health information about you and your health care is personal. We are committed to
protecting your health information. We create a record of the care and services you receive.
This record is needed to provide you with quality care and to comply with certain legal
requirements. This notice applies to all of the records of your care generated by this
practice. This notice will tell you about the ways in which we may use and disclose your
health information. This notice also describes your rights to the health information kept
about you, and describes certain obligations we have regarding the use and disclosure of
your health information. We are required by law to:

Make sure that protected health information (“PHI”) that identifies you is kept
private.
Give you this notice of my legal duties and privacy practices with respect to
health information.
Follow the terms of the notice that is currently in effect.
We can change the terms of this Notice, and such changes will apply to all
information I have about you. The new Notice will be available upon request, in
my office, and on my website.

II. HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:
The following categories describe different ways that we may use and disclose health
information. For each category of uses or disclosures, we will explain what I mean and try to
give some examples. Not every use or disclosure in a category will be listed. However, all of
the ways we are permitted to use and disclose information will fall within one of the
categories.
For Treatment Payment, or Health Care Operations: Federal privacy rules (regulations)
allow health care providers who have direct treatment relationship with the patient/client to
use or disclose the patient/client’s personal health information without the patient’s written
authorization, to carry out the health care provider’s own treatment, payment or health care
operations. We may also disclose your protected health information for the treatment
activities of any health care provider. This too can be done without your written
authorization. For example, if a health care provider were to consult with another licensed
health care provider about your condition, we would be permitted to use and disclose your
personal health information, which is otherwise confidential, in order to assist the health
care provider in diagnosis and treatment of your condition.

Disclosures for treatment purposes are not limited to the minimum necessary standard.
Because other health care providers need access to the full record and/or full and complete
information in order to provide quality care. The word “treatment” includes, among other
things, the coordination and management of health care providers with a third party,
consultations between health care providers and referrals of a patient for health care from
one health care provider to another.
Lawsuits and Disputes: If you are involved in a lawsuit, we may disclose health information
in response to a court or administrative order. We may also disclose health information
about your child in response to a subpoena, discovery request, or other lawful process by
someone else involved in the dispute, but only if efforts have been made to tell you about
the request or to obtain an order protecting the information requested.

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

Session Notes: We do keep “Session notes” and any use or disclosure of such
notes requires your Authorization unless the use or disclosure is:
a. For use in treating you.
b. For use in training or supervising associates to help them improve their
clinical skills.
c. For use in defending our business and any employees in legal proceedings
instituted by you.
d. For use by the Secretary of Health and Human Services to investigate our
compliance with HIPAA.
e. Required by law and the use or disclosure is limited to the requirements of
such law.
f. Required by law for certain health oversight activities pertaining to the
originator of the session notes.
g. Required by a coroner who is performing duties authorized by law.
h. Required to help avert a serious threat to the health and safety of others.
Marketing Purposes. Healthcare providers, will not use or disclose your PHI for
marketing purposes.
Sale of PHI. Healthcare providers, will not sell your PHI in the regular course of
my business.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION.
Subject to certain limitations in the law, we can use and disclose your PHI without your
Authorization for the following reasons:

When disclosure is required by state or federal law, and the use or disclosure
complies with and is limited to the relevant requirements of such law.
For public health activities, including reporting suspected child, elder, or
dependent adult abuse, or preventing or reducing a serious threat to anyone’s
health or safety.
For health oversight activities, including audits and investigations.
For judicial and administrative proceedings, including responding to a court or
administrative order, although my preference is to obtain an Authorization from
you before doing so.
For law enforcement purposes, including reporting crimes occurring on my
premises.
To coroners or medical examiners, when such individuals are performing duties
authorized by law.
For research purposes, including studying and comparing the patients who
received one form of care versus those who received another form of care for
the same condition.
Specialized government functions, including, ensuring the proper execution of
military missions; protecting the President of the United States; conducting
intelligence or counterintelligence operations; or, helping to ensure the safety of
those working within or housed in correctional institutions.
For workers’ compensation purposes. Although my preference is to obtain an
Authorization from you, we may provide your PHI in order to comply with
workers’ compensation laws.
Appointment reminders and health-related benefits or services. We may use
and disclose your PHI to contact you to remind you that you have an
appointment with me. We may also use and disclose your PHI to tell you about
treatment alternatives, or other healthcare services or benefits that we offer.
V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY
TO OBJECT.
Disclosures to family, friends, or others. I may provide your PHI to a family member, friend,
or other person that you indicate is involved in your care or the payment for your healthcare,
unless you object in whole or in part. The opportunity to consent may be obtained
retroactively in emergency situations.

VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

The Right to Request Limits on Uses and Disclosures of Your PHI. You have the
right to ask me not to use or disclose certain PHI for treatment, payment, or
health care operations purposes. We are not required to agree to your request,
and we may say “no” if we believe it would affect your health care.
The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full.
You have the right to request restrictions on disclosures of your PHI to health
plans for payment or health care operations purposes if the PHI pertains solely
to a health care item or a health care service that you have paid for out-of-
pocket in full.
The Right to Choose How I Send PHI to You. You have the right to ask us to
contact you in a specific way (for example, home or office phone) or to send
mail to a different address, and we will agree to all reasonable requests.
The Right to See and Get Copies of Your PHI. Other than “session notes,” you
have the right to get an electronic or paper copy of your medical record and
other information that we have about you. We will provide you with a copy of
your record, or a summary of it, if you agree to receive a summary, within 30
days of receiving your written request, and we may charge a reasonable, cost-
based fee for doing so.
The Right to Get a List of the Disclosures We Have Made. You have the right to
request a list of instances in which we have disclosed your PHI for purposes
other than treatment, payment, or healthcare operations, or for which you
provided us with an Authorization. We will respond to your request for an
accounting of disclosures within 60 days of receiving your request. The list we
will give you will include disclosures made in the last six years unless you
request a shorter time. We will provide the list to you at no charge, but if you
make more than one request in the same year, we will charge you a reasonable
cost-based fee for each additional request.
The Right to Correct or Update Your PHI. If you believe that there is a mistake in
your PHI, or that a piece of important information is missing from your PHI, you
have the right to request that we correct the existing information or add the
missing information. I may say “no” to your request, but we will tell you why in
writing within 60 days of receiving your request.
The Right to Get a Paper or Electronic Copy of this Notice. You have the right
get a paper copy of this Notice, and you have the right to get a copy of this
notice by e-mail. And, even if you have agreed to receive this Notice via e-mail,
you also have the right to request a paper copy of it.

EFFECTIVE DATE OF THIS NOTICE
This notice went into effect on February 1, 2023.