Carlsbad Integrative Medical Center Incorporated
Jeremy Whiting, D.O.
5814 Van Allen Way, Ste. 215
Carlsbad, CA 92008
Phone: (760) 444-5544 Fax: (760) 444-5006
NOTICE OF PRIVACY PRACTICES:
Effective January 1, 2018. This notice describes how medical information about you may
be used and disclosed and how you can get access to this information. Please review this carefully. Persons who will abide by this notice include any healthcare professional authorized to discuss your medical information with others that you designate.
Your Rights Concerning Your Medical Information.
The following are your rights concerning medical information we maintain about you:
- Right to Inspect and Copy: You have a right to inspect and copy medical information that may be used to make decisions about your healthcare. This usually includes medical and billing records, but does not include psychotherapy notes. In order to obtain a copy of your medical information or to review it, you must submit a request in writing to the acting director at that time. We may charge a fee for the cost of copying or otherwise processing your request. We can also deny your request to copy and inspect under limited circumstances, and if such denial is made, you may request to view that denial. Dr. Jeremy Whiting, D.O., will review the request and denial, and we will comply with the result of the review.
- Right to Amend. You may request that we amend the medical information that we have about you if you believe it is incorrect or incomplete. This right to request amendment remains as long as Dr. Jeremy Whiting, D.O., keeps your medical chart. Requests to amend medical information must include a supporting reason for the request, and must be made in writing and submitted to this office staff. We may deny your request if the above requirements are not met. We may also deny your requests for the following reasons: a) The information was not created by Dr. Jeremy Whiting, D.O.; b) The information is not part of the medical information maintained by this office; c) The information is not part of the medical information you are otherwise allowed to copy or inspect; d) The information is already complete or accurate.
- Right to Accounting of Disclosures of Medical Information. You have a right to request an accounting, or list of disclosures we made of medical information about you. A written request must be submitted to Dr. Jeremy Whiting, D.O., before any list of disclosures can be processed. Such request must include a time period no longer than seven years and may not include any dates before January 1, 2018. The first list requested for a 12-month period will be provided free of charge; however, we may charge you a fee for subsequent lists. We will inform you of the costs of processing such a request before fulfilling your request in case you wish to change or withdraw your request.
- Right to Request Restrictions. You have the right to request that a limitation or restriction be placed on your medical information for treatment, payment, or healthcare operations. You can also request limits on the medical information we disclose about you to someone involved in your care, like family or friends. An example would be a request that we not disclose a specific treatment you received. Although we are not required to comply with your request, we will if we agree, unless you need emergency treatment and the information is needed for that purpose. Requests for restrictions must be made in writing to Dr. Jeremy Whiting, D.O., and must include the information you wish to limit; whether it is the use or disclosure or both you wish us to limit, and to whom the limits should apply; e.g., disclosures to a parent.
- Right to Request Confidential Communications. You have the right to request that we may communicate with you about medical issues in a specific manner and at a specific locations, such as at work or by email. You must submit a written request for confidential communications to Jeremy Whiting, D.O. We will do our best to fulfill all reasonable requests. You must indicate how and where you wish us to contact you.
- Right to Paper Copy of Notice. You have the right to receive a paper copy of this notice and may request one from us at any time. Those patients receiving copies electronically may still receive a paper copy of the notice. Please contact this office in order to obtain a copy.
- Changes to the Notice. We reserve the right to amend this notice. The revised or changed notice may be effective for medical information already obtained about you as well as future information received. A copy of the current notice will be posted in your medical chart, and the effective date will be the date you sign below, at the end of this document.
- Complaints. If you have a concern or complaint about how your protected health information is being used, please first contact Dr. Jeremy Whiting, D.O., to resolve your concerns.
- Other Uses of Medical Information. We will disclose only medical information about you (not described in this notice or covered by laws that apply to us) with your written permission. You may revoke your permission to use or disclose your medical information by doing so in writing at any time. At that time, we will no longer use or disclose your medical information for those reasons specified in your authorization. You understand that disclosures already made with your permission cannot be reclaimed and that we are required to keep records of your healthcare provided by you.