HIPAA Notice of Privacy Practices
Draft for legal review. This page is a working draft and must be reviewed and approved by counsel, and reconciled with Ascend Rx's actual practices, before the site goes live.
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
Ascend Rx is required by law to maintain the privacy of your protected health information, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.
How we may use and disclose your health information
[To be completed by counsel — must describe treatment, payment, and health care operations uses, disclosures required by law, and any other categories applicable to Ascend Rx's operations.]
Your rights
[To be completed by counsel — right to access, amend, request restrictions, request confidential communications, receive an accounting of disclosures, and obtain a paper copy of this notice.]
Complaints
[To be completed by counsel — must include how to file a complaint with Ascend Rx and with the Secretary of the U.S. Department of Health and Human Services, and a statement that you will not be retaliated against.]
Effective date and contact
[Effective date to be inserted.] Privacy questions may be directed to our Privacy Officer at 8600 NW 17th Street, Suite 100, Doral, FL 33126.