Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities. This notice is required under HIPAA and describes how your medical information may be used and disclosed, and how you can access it. Please review it carefully.

You have the right to:

  • Get a copy of your paper or electronic medical record

  • Correct your paper or electronic medical record

  • Request confidential communication

  • Ask us to limit the information we share

  • Get a list of those with whom we've shared your information

  • Get a copy of this privacy notice

  • Choose someone to act for you

  • File a complaint if you believe your privacy rights have been violated

Your Rights

You have some choices in the way that we use and share information as we:

  • Tell family and friends about your condition

  • Provide disaster relief

  • Include you in a hospital directory

  • Provide mental health care

  • Market our services and sell your information

  • Raise funds

Your Choices

We may use and share your information as we:

  • Treat you

  • Run our organization

  • Bill for your services

  • Help with public health and safety issues

  • Do research

  • Comply with the law

  • Respond to organ and tissue donation requests

  • Work with a medical examiner or funeral director

  • Address workers' compensation, law enforcement, and other government requests

  • Respond to lawsuits and legal actions

To the extent that we have your substance use disorder patient records, subject to 42 CFR Part 2, we will not share that information for investigations or legal proceedings against you without (1) your written consent or (2) a court order and a subpoena.

Our Uses and Disclosures

Get an electronic or paper copy of your medical record
You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record
You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may say "no" to your request, but we'll tell you why in writing within 60 days.

Request confidential communications
You can ask us to contact you in a specific way (for example, home, office, or cell phone) or to send mail to a different address. We will say "yes" to all reasonable requests.

Ask us to limit what we use or share
You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say "no," for example, if it could affect your care. If we agree, we may still share this information if you need emergency treatment. If you pay out-of-pocket in full for a service, you can ask us not to share that information with your health insurer for payment or operations purposes. We will say "yes" unless a law requires us to share it.

Get a list of those with whom we've shared information
You can ask for a list (accounting) of the times we've shared your health information for six years prior to your request, who we shared it with, and why. We include all disclosures except those for treatment, payment, and health care operations, and certain other disclosures you've asked us to make. One accounting per year is free; we may charge a reasonable fee for additional requests within 12 months.

Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you've agreed to receive it electronically. We will provide a paper copy promptly.

Choose someone to act for you
If someone has authority to act as your personal representative, such as a medical power of attorney or legal guardian, that person can exercise your rights and make choices about your health information. We will verify that authority before taking any action.

File a complaint if you feel your rights are violated
You can complain by contacting us using the information below. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, by mail (200 Independence Avenue, S.W., Washington, D.C. 20201), phone (1-877-696-6775), or online at hhs.gov/hipaa/filing-a-complaint. We will not retaliate against you for filing a complaint.

Your Rights, in Detail

For certain health information, you can tell us your preferences directly. In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your care or payment for your care

  • Share information in a disaster relief situation

  • Include your information in a hospital directory

If you're unable to state a preference, for example if you're unconscious, we may share your information if we believe it's in your best interest, or when needed to reduce a serious and imminent threat to health or safety.

In these cases, we never share your information unless you give us written permission:

  • Marketing purposes

  • Sale of your information

  • Most sharing of psychotherapy notes

For fundraising, we may contact you, but you can tell us to stop at any time. If we hold substance use disorder patient records subject to 42 CFR Part 2, we will give clear notice in advance and a choice about receiving fundraising communications that use that information.

Your Choices, in Detail

Our Uses and Disclosures, in Detail

Treat you
We use and share your health information with other professionals treating you. Example: a doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization
We use and share your health information to run our practice, improve your care, and contact you when necessary.

Bill for your services
We use and share your health information to bill and get payment from health plans or other entities.

We're also allowed or required to share your information in other ways that serve the public good, such as public health and research, subject to conditions required by law. If we hold substance use disorder patient records subject to 42 CFR Part 2, we cannot use or share that information in civil, criminal, administrative, or legislative proceedings against you without your consent or a court order and subpoena.

  • Public health and safety: preventing disease, product recalls, reporting adverse drug reactions, reporting suspected abuse or neglect, and preventing serious threats to health or safety

  • Research: we may use or share information for health research

  • Legal compliance: we share information as required by state or federal law

  • Organ and tissue donation: we may share information with organ procurement organizations

  • Medical examiners and funeral directors: we may share information when an individual dies

  • Workers' compensation, law enforcement, and government functions: for workers' compensation claims, law enforcement purposes, health oversight activities, and special government functions such as military or national security

  • Lawsuits and legal actions: we may share information in response to a court order or subpoena

  • We're required by law to maintain the privacy and security of your protected health information.

  • We'll notify you promptly of any breach that may have compromised your information.

  • We must follow the practices described in this notice and provide you a copy of it.

  • We won't use or share your information beyond what's described here unless you authorize it in writing, and you may revoke that authorization at any time.

More information: hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

Our Responsibilities

We may change the terms of this notice, and any changes will apply to all information we already have about you. The updated notice will be available on request, at our office, and on this website.

Changes to This Notice

Florida law (Fla. Stat. § 456.057) provides additional protection for your medical records. Except as otherwise permitted or required by law, your medical records and the discussion of your medical condition will not be shared with anyone other than you, your legal representative, or other health care providers involved in your care, without your written authorization.

Florida Law

Dr. Bryce Goeden, D.C.
Phone: (813) 521-0360
Email: welcome@vitalfoundationshealth.com

Contact & Privacy Official