Privacy Policy
Effective: July 1, 2011
OUR RESPONSIBILITIES
Starlight Medical Group takes the privacy of your health information seriously. We are required by law to maintain privacy and to provide you with this Notice of Privacy Practices. This notice is provided to advise of our statement of duties and practices with respect to your information. Statement is available upon request.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
Other uses and disclosures of 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 your health information, 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 reasons covered by your written authorization. You understand we are unable to take back any disclosures we have already made under the authorization and are required to retain our records of the care we provided to you.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the following rights regarding health information we maintain about you:
- Right to request restrictions
- Right to request confidential information
- Right to inspect and copy
- Right to amend
- Right to a paper copy of this notice
You may obtain a copy of this notice at our office.
WHO THIS NOTICE APPLIES TO
This statement describes Starlight Medical Group practices.
- Any health care professional authorized to enter information into and/or consult your medical record.
- All employees, staff and other Starlight Medical Group personnel.
CHANGES TO THIS NOTICE
We reserve the right to change this statement from time to time.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized for filing a complaint. If you have any questions about this notice, please contact:
John Evans
Starlight Medical Group
2621 Windguard Circle
Wesley Chapel, FL 33544