Effective Date: 01/01/2026
THIS NOTICE EXPLAINS HOW YOUR MEDICAL INFORMATION MAY BE USED OR SHARED AND HOW YOU CAN ACCESS IT. PLEASE READ CAREFULLY.
If you have questions or need more details about this notice, please contact our Privacy Officer:
Privacy Officer: Rabia Akbar
Mailing Address: 3525 Lawrenceville-Suwanee Rd, Suite 101, Suwanee, GA 30024
Phone: 770-927-8180 | Fax: 678-473-4739
We are legally required to protect your Protected Health Information (PHI) and to provide you with this notice about our privacy practices. This notice outlines your rights and our responsibilities regarding your PHI. We must follow the terms of this notice.
PHI refers to information that identifies you personally and is created or received by us or other healthcare providers, health plans, employers, or clearinghouses. It relates to your physical or mental health (past, present, or future), the healthcare you receive, or payment for your healthcare.
For Treatment: We use PHI to provide and coordinate your medical care, including sharing information with other healthcare professionals involved in your treatment.
For Payment: We use and share PHI to bill and collect payment from you, your insurance, or other payers. This may include providing information to your health plan or collection agencies if necessary.
For Healthcare Operations: We use PHI for business activities such as staff performance reviews, cost management, audits, and legal services. We may also share PHI with other entities for their operations, like your insurer for quality reviews.
Appointment Reminders and Health Information: We may contact you about appointments, treatment options, or health-related benefits and services.
Minors: PHI of minors may be shared with parents or guardians unless prohibited by law.
Personal Representatives: Legal guardians or representatives are treated as the patient regarding PHI disclosures.
As Required by Law: We will share PHI when required by international, federal, state, or local laws.
To Prevent Serious Threats: PHI may be shared to prevent serious threats to health or safety.
Business Associates: We may share PHI with companies that provide services for us, such as billing or consulting, under contracts requiring them to protect your information.
Organ and Tissue Donation: PHI may be shared with organizations involved in organ or tissue donation.
Military and Veterans: PHI may be released as required by military authorities.
Workers’ Compensation: PHI may be used for workers’ compensation claims.
Public Health Risks: PHI may be disclosed for public health activities, such as reporting diseases, child abuse, product recalls, or exposure to communicable diseases.
Health Oversight Activities: PHI may be shared with agencies for audits, inspections, and other oversight activities.
Lawsuits and Disputes: PHI may be disclosed in response to court orders or legal processes.
Law Enforcement: PHI may be released to law enforcement for specific reasons, such as locating suspects or reporting crimes.
National Security: PHI may be shared with federal officials for national security purposes.
Coroners, Medical Examiners, and Funeral Directors: PHI may be released to these professionals as needed.
Inmates: PHI may be disclosed to correctional institutions or law enforcement if necessary for your care or safety.
Individuals Involved in Your Care: PHI may be shared with family or friends involved in your care or payment, unless you object.
Disaster Relief: PHI may be shared with disaster relief organizations to coordinate care or notify loved ones, unless you object.
Marketing and Sale of PHI: These uses require your written permission.
Other Uses: Any other use or disclosure not covered by this notice or applicable laws requires your written authorization. You may revoke your authorization at any time in writing.
Additional privacy protections apply to HIV-related information, substance abuse, mental health, and genetic data. . Some parts of this general Notice of Privacy Practices may not apply to these kinds of PHI. Please check with our Privacy Officer for information about the special protections that do apply.
Right to Inspect and Copy: You may review or obtain copies of your PHI, except psychotherapy notes. Fees may apply, except for certain benefit claims. If denied, you can request a review.
Right to Electronic Copies: If your PHI is electronic, you can request an electronic copy or transmission to another party. Fees may apply.
Right to Notice of Breach: You will be notified of any breach of your unsecured PHI.
Right to Request Amendments: You may request corrections to your PHI in writing, stating the reason. We may deny requests under certain circumstances.
Right to Accounting of Disclosures: You can request a list of PHI disclosures, except for certain types. The first request in a 12-month period is free; additional requests may incur a fee.
Right to Request Restrictions: You may ask us to limit how we use or share your PHI. We are not required to agree, but will comply if we do.
Right to Restrict Disclosures to Health Plans: You can restrict disclosures to health plans for services paid out-of-pocket in full.
Right to Confidential Communications: You may request specific ways for us to contact you. Requests must be in writing.
Right to a Paper Copy: You may request a paper copy of this notice at any time, even if you receive it electronically.
Send written requests to our Privacy Officer at the address above. We may ask you to complete a form.
We may change this notice at any time. Changes apply to all PHI we have or receive in the future. The current notice is posted in our office and on our website.
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of Health and Human Services. Complaints must be in writing and submitted within 180 days of the suspected violation. There will be no retaliation for filing a complaint.