Last updated: June 23, 2025
Your Information. Your Rights. Our Responsibilities.
This notice describes how your medical information may be used and disclosed, and how you can access it.
Your Rights
Get a copy of your medical record
- You can ask for an electronic or paper copy of your medical record and other health information we have about you.
- We will provide a copy or summary, usually within 30 days. We may charge a reasonable, cost-based fee.
Ask us to correct your record
- You can ask us to correct health information about you that you think is incorrect or incomplete.
- We may say "no" to your request, but we'll tell you why in writing within 60 days.
Ask us to limit what we use/share
- You can ask us to correct health information about you that you think is incorrect or incomplete.
- We may say "no" to your request, but we'll tell you why in writing within 60 days.
Get a list of who we’ve shared info with
- You can ask for a list (accounting) of times we've shared your health information for six years prior, who we shared it with, and why.
- We'll include all disclosures except treatment, payment, operations, and certain others. One accounting per year is free; we charge for additional requests within 12 months.
Request confidential communications
- You can ask us to contact you in a specific way (home or office phone) or send mail to a different address.
- We will say "yes" to all reasonable requests.
Other rights
- Get a copy of this privacy notice
- Choose someone to act for you
- File a complaint: Contact us or HHS Office for Civil Rights if you feel rights were violated.
We will not retaliate against you for filing a compliant.
Your Choices
You have both the right and choice to tell us to:
- Share information with family, close friends, or others involved in your care
- Share information in disaster relief situations
- Include your information in a hospital directory
If you are unable to tell us your preferences, we may share if we believe it is in your best interest or to lessen serious/imminent threats to health or safety.
We NEVER share unless you give written permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
We may contact you for fundraising, but you can opt out.
Our Uses and Disclosures
Treat You
- We can use your health information and share it with other professionals treating you.
Bill for Your Services
- We can use and share your health information to bill and get payment from health plans or other entities.
Do Research
- We can use or share your information for health research under specific conditions required by law.
Respond to Organ and Tissue Donation Requests
- We can share health information with organ procurement organizations.
Respond to Lawsuits and Legal Actions
- We can share health information in response to a court or administrative order, or in response
to a subpoena.
Run our Organization
- We can use and share your health information to run our practice, improve your care, and
contact you when necessary.
Help with Public Health and Safety Issues
- We can share for: preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect, or domestic violence preventing or reducing serious threats to health or safety
Comply with the Law
- We will share information if state or federal laws require it, including with the Department of Health and Human Services to verify compliance with federal privacy law.
Work with Medical Examiner or Funeral Director
- We can share health information with a coroner, medical examiner, or funeral director when an
individual dies.
Address Workers' Compensation, Law Enforcement, and Government Requests
- We can use or share for: workers' compensation claims, law enforcement purposes, health oversight agencies for authorized activities, special government functions
Our Responsibilities
- We are required by law to maintain privacy and security of your health information
- We will notify you promptly of any breach that may have compromised your information
- We must follow duties and practices in this notice and provide you a copy
- We will not use/share your information beyond what's described without your written permission
- You can revoke written permission anytime by notifying us in writing
- We can change notice terms; changes apply to all information we have about you
Questions or Complaints?
Contact Us
Metro Vein Centers
1-800-361-8791
[email protected]
Contact HHS about a Concern
U.S. Department of Health & Human Services
Office for Civil Rights
1-877-696-6775
hhs.gov/ocr/privacy/hipaa/complaints