Privacy Policy

WE CARE ABOUT YOUR PRIVACY AND ARE COMMITTED TO PROTECTING YOUR

HEALTH INFORMATION. THIS PATIENT PRIVACY POLICY DESCRIBES HOW YOUR

MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS

THIS INFORMATION.

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PLEASE REVIEW IT CAREFULLY.

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Effective Date of Notice: 06-16-2025

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Your Rights

● You have a right to a copy of your medical record. We will provide a copy usually within 15 days of your request.

● 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.

● You can ask us to contact you in a specific way (for example, by home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.

● You can ask for a copy of this policy at any time.

● You can file a complaint with us if you feel we have violated your privacy by contacting us using the contact information above. We will not retaliate against you for filing a complaint.

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Your Choices

● You can tell us your choices about whether and what we share with your family, close friends, or others involved in your care.

● If you cannot tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to your health or safety.

● We will not use your information for marketing purposes without your written permission.

● We may contact you for fundraising efforts, but you can tell us not to contact you again.

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Our Uses and Disclosures

● We can use your health information and share it with other professionals who are treating you. Example: Sharing your ultrasound images with a medical professional for interpreting purposes.

● We can use and share your health information to run our practice, improve your care, and contact you when necessary. We will share information about you if required by applicable state or federal laws such as workers’ compensation, law enforcement, and other government requests.

● We can share health information about you in response to a court or administrative order or in response to a subpoena if required by law.

● For uses beyond these, we will ordinarily obtain your written authorization.

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Our Responsibilities

● We abide by applicable state and federal laws to maintain the privacy and security of your health information.

● We will follow all applicable state and federal laws if a breach occurs that may have compromised the privacy or security of your health information.

● We will not use or share your information other than as 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.

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Changes to the Terms of this Patient Privacy Policy

We can change the terms of this policy, which will apply to all information we have about you. The new policy will be available upon request in our office and on our website.

 

For more information see:

• https://www.texasattorneygeneral.gov/consumer-protection/health-care/patient-privacy

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Contact Information:

• If you need to report a privacy violation, file a complaint with Texas Health and Human Services

by calling 2-1-1 or 877-541-7905, toll-free. If you are hearing or speech impaired, you may call 7-1-1 or 800-735-2989 (TTY).

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• Or you can complete the Form H0404 Privacy Complaint found at:

https://www.hhs.texas.gov/regulations/forms/0-999/form-h0404-privacy-complaint

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• available in English and Spanish and send it to:

HHS Privacy Division

P.O. Box 149030

Mail Code 1355

Austin, TX 78714

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Or you may email your complaint to the HHS Privacy Division at privacy@hhs.texas.gov

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We will not retaliate against you for filing a complaint.

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Who to contact at Willow Grove Care Center for more information?

We want you to feel comfortable asking questions or raising concerns. If you would like more information about our privacy practices—or if you believe your privacy rights may have been violated, you can contact our Privacy Officer at:

Willow Grove Care Center

101 W. Crawford Street

Palestine, TX. 75801

Phone: 903-723-9944

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Please know that Willow Grove Care Center will never retaliate against anyone for filing a complaint.