Augustine is committed to protecting the confidentiality of your health information. We have policies and safeguards in place to ensure your privacy. Augustine is also required by state and federal laws to protect the confidentiality of your health information.
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.
The confidential health information that we collect as we deliver care or services to you is called "protected health information". We can use and disclose your protected health information:
You also have the following rights regarding the use and disclosure of your protected health information:
If you believe that your confidentiality has been violated, you can contact David Mainguy, the Augustine privacy officer at the Corporate Service Center in Maryland at 410-479-1939 to file a complaint or you can file a complaint with the office of the Secretary of Health and Human Services. We want to hear your concerns, and you will not be retaliated against if you file a complaint.
If you wish to see your protected health information, receive a copy of it or ask to amend it, please contact David Mainguy at the Augustine Corporate Service Center in Maryland at 1-800-864-1276.
If anyone wishes to use or access your protected health information for reasons other than to provide care, obtain payment or run our operations, we can only release it with your written authorization. And, you may revoke that authorization at any time.
However, there are some important exceptions to requiring an authorization stated in the federal regulation. We can provide your protected health information to representatives of the following organizations without your written authorization or without obtaining your agreement or objection:
We may not disclose your health information if you are the subject of an investigation unless your health information is directly related to your receipt of public benefits.
We at Augustine abide by this Notice effective April 14, 2003. The Notice is available to any individual upon request. We do reserve the right to change the terms of this Notice, and to provide the revised Notice to any patient/client who is receiving care or services. Augustine reserves the right to change this Notice of Privacy Practices; and if we do so, the changes will apply with respect to your protected health information in our possession.
If you have any concerns about this Notice or wish to have additional information, you may contact David Mainguy who is our corporate Privacy Officer at 800-864-1276. We welcome your questions, as the privacy of your protected health information is one of our most important promises to you.
This notice can be requested in writing by sending your request to
PO Box 2058
Garner, NC 27529
Phone: (301) 816-5020
Fax: (301) 816-5039
Phone: (214) 265-5055
Fax: (214) 265-3904
Phone: (214) 265-9022
Fax: (214) 265-3904
Phone: (469) 467-3306