Notice of Privacy Practices

Effective Date: March 5, 2025

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Commitment to Your Privacy

At Jubilee Clinic, we are dedicated to maintaining the privacy and security of your health information. This Notice of Privacy Practices outlines how we may use and disclose your Protected Health Information (PHI) and details your rights regarding this information.

Who Will Follow This Notice

This notice applies to all Jubilee Clinic staff, healthcare professionals, and entities associated with our clinic.

Understanding Your Health Record

Each time you visit Jubilee Clinic, a record of your visit is made. This record contains your symptoms, examination results, diagnoses, treatment plans, and billing information. This information, often referred to as your health or medical record, serves as:

• A basis for planning your care and treatment.
• A means of communication among the healthcare professionals who contribute to your care.
• A legal document describing the care you received.
• A tool for educating health professionals.
• A source of data for medical research.
• A source of information for public health officials charged with improving the health of the nation.
• A source of data for facility planning and marketing.
• A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.

Your Health Information Rights

Although your health record is the physical property of Jubilee Clinic, the information belongs to you. You have the right to:

• Inspect and Copy: You can inspect and obtain a copy of your health record, as provided by law.
• Amend: If you believe the information in your record is incorrect or incomplete, you may request an amendment.
• Accounting of Disclosures: Request a list of disclosures of your health information made by us, except for treatment, payment, and healthcare operations.
• Request Restrictions: Ask us to limit the information we share about you for treatment, payment, or healthcare operations. While we are not required to agree, we will consider your request.
• Confidential Communications: Request that we communicate with you about medical matters in a certain way or at a certain location.
• Paper Copy of This Notice: Obtain a paper copy of this notice upon request.

To exercise any of these rights, please contact our Privacy Officer at the address provided at the end of this notice.

Our Responsibilities

Jubilee Clinic is required to:

• Maintain the privacy of your health information.
• Provide you with this notice of our legal duties and privacy practices.
• Abide by the terms of this notice.
• Notify you if we are unable to agree to a requested restriction.
• Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.
• Notify you promptly if a breach occurs that may have compromised the privacy or security of your information.

How We May Use and Disclose Your Health Information

The following categories describe different ways that we use and disclose health information. Not every use or disclosure in a category will be listed.

• Treatment: We may use and disclose your health information to provide, coordinate, or manage your healthcare and related services. For example, we may share information with other healthcare providers involved in your care.
• Payment: We may use and disclose your health information to obtain payment for the healthcare services provided. This can include billing you, your insurance company, or a third party.
• Healthcare Operations: We may use and disclose your health information for operations necessary to run Jubilee Clinic and ensure quality care. This includes activities like quality assessments, employee evaluations, training programs, and accreditation processes.
• Appointment Reminders: We may contact you to remind you of upcoming appointments.
• Treatment Alternatives and Health-Related Benefits: We may inform you about treatment options, services, or health-related benefits that may interest you.

Special Situations

• Public Health Risks: We may disclose your health information for public health activities such as controlling disease, injury, or disability.
• Health Oversight Activities: We may disclose health information to health oversight agencies for activities authorized by law, including audits and investigations.
• Lawsuits and Disputes: If you are involved in a lawsuit or dispute, we may disclose your health information in response to a court order or other lawful process.
• Law Enforcement: We may release health information to law enforcement officials as required by law or in response to a valid subpoena.
• Coroners, Medical Examiners, and Funeral Directors: We may disclose health information to these professionals to carry out their duties.
• Organ and Tissue Donation: If you are an organ donor, we may release health information to organizations involved in organ procurement or transplantation.
• Research: Under certain circumstances, we may use and disclose health information for research purposes.
• To Avert a Serious Threat to Health or Safety: We may use and disclose health information when necessary to prevent a serious threat to your health and safety or the health and safety of the public.

Your Written Authorization

Other uses and disclosures of your health information not covered by this notice or the laws that apply to us will be made only with your written authorization. If you provide us authorization to use or disclose health information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose health 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 authorization and that we are required to retain our records of the care that we provided to you.

Changes to This Notice

We reserve the right to change this notice and make the new provisions effective for all protected health information we maintain. We will post a copy of the current notice in our facility and on our website. The notice will contain the effective date on the first page.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with us, contact our Privacy Officer at the address listed below. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

Contact Information

If you have any questions about this notice or wish to exercise any of your rights, please contact:

Privacy Officer

Jubilee Clinic

1519 9th St Marysville, WA 98270

Phone: (360) 777-4090

Email: care@jubileeclinicdpc.com