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Economy Hearing Aid Centers, Inc.
Economy Hearing Aid Center, An Oklahoma Corporation
1401 S Fretz Drive
Edmond, OK 73003
Privacy Notice
effective 04/13/2003
This document describes the type of information the Economy Hearing Aid Centers, Inc. and Economy Hearing Aid Centers, an Oklahoma Corporation gathers about you, with whom that information may be shared, and the safeguards we have in place to protect it. You have the right to the confidentiality of your medical information and the right to approve or refuse the release of specific information except when the release is required by law. If the practices described in this notice meet your expectations, there is nothing you need to do. If you prefer that we not share information, we may honor your written request in certain circumstances described below. If you have any questions regarding this Privacy Notice, please contact our Assistant Privacy Officer at the corporate office.
Who Will Follow This Notice?
This notice describes the Economy Hearing Aid Centers Inc. and Economy Hearing Aid Centers, a Oklahoma Corporation practices regarding:
Our Pledge Regarding Medical Information
We understand that medical information about you and your health is personal. We are committed to protecting the confidentiality of your medical information. As part of our routine operations, we create a record of the care and services you receive. We need this record 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 Economy Hearing Aid Centers, Inc. or Economy Hearing Aid Center, a Oklahoma Corporation. Your personal doctor may have different policies or notices regarding the doctor's use and disclosure of your medical information created in the doctor's office or clinic.
This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.
Federal law requires us to:
How We May Use and Disclose Medical Information About You
The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we 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.
Special Disclosure Situations
Your Rights Regarding Medical Information About You
You have the following rights regarding medical information we maintain about you:
To request restrictions, you must make your request in writing to the corporate office. Upon Receipt of request, the request will be immediately taken to the proper authority in our organization. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
Changes to this Notice
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in the facility. The notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you register at or the facility for treatment, you may request a current copy.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with Economy Hearing Aid Centers, Inc. or with the Secretary of the Department of Health and Human Services. To file a complaint with Economy Hearing Aid Centers, Inc., contact Economy Hearing Aid Centers, Inc. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
Other Uses of Medical Information
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
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