Uses and Disclosures Of PHI That Do Not Require Your Prior Authorization
We may use or disclose your PHI to provide and coordinate the treatment, goods and services you receive.
We may use and disclose your PHI in order to obtain payment for the products and services that we provide to you and for other payment activities related to the services that we provide.
- Health Care Operations.
We may use and disclose your PHI for our health care operations. We may also disclose your PHI to other HIPAA covered entities that have provided services to you.
Uses and Disclosures of PHI that Require Your Prior Authorization
- Specific Uses or Disclosures Requiring Authorization.
We will obtain your written authorization for the use or disclosure of psychotherapy notes, use or disclosure of PHI for marketing, and for the sale of PHI, except in limited circumstances.
- Other Uses and Disclosures.
We will obtain your written authorization before using or disclosing your PHI for purposes other than those described in this Notice or otherwise permitted by law. You may revoke an authorization in writing at any time.
Your Health Information Rights
Obtain a paper copy of the Notice upon request.
You may request a copy of our current Notice at any time.
Request a restriction on certain uses and disclosures of PHI.
You have the right to request additional restrictions on our use or disclosure of your PHI by sending a written request to the Privacy Office.
Inspect and obtain a copy of PHI.
With a few exceptions, you have the right to access and obtain a copy of the PHI that we maintain about you. You may ask us to send a copy of your PHI to other individuals or entities that you designate.
Request an amendment of PHI.
If you feel that PHI we maintain about you is incomplete or incorrect, you may request that we amend it.
Receive an accounting of disclosures of PHI.
With the exception of certain disclosures, you have a right to receive a list of the disclosures we have made of your PHI, in the six years prior to the date of your request, to entities or individuals other than you.
Request communications of PHI by alternative means or at alternative locations.
You have the right to request that we communicate with you about health matters in a certain way or at a certain location. We will accommodate all reasonable requests.
Notification of a Breach.
You have a right to be notified following a breach of your unsecured PHI, and we will notify you in accordance with applicable law.
Where to obtain forms for submitting written requests.
You may obtain forms for submitting written requests by contacting PharmaCann LLC, 1140 Lake Street, Suite 304, Oak Park, Illinois 60301. You can also visit www.PharmaCannis.com to obtain these forms.
For More Information or to Report a Problem.
If you have questions or would like additional information about the PharmaCann privacy practices, you may contact PharmaCann LLC, 1140 Lake Street, Suite 304, Oak Park, Illinois 6030. If you believe your privacy rights have been violated, you can file a complaint with PharmaCann or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.
Effective Date. This Notice is effective as of February 10, 2016