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

I. WE HAVE A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION (PHI).
 We are legally required to protect the privacy of your health information. We call this information protected health information, or PHI for short, and it includes information that can be used to identify you that we created or received about your past, present, or future health or condition, the provision of health care to you, or the payment of this health care. We must provide you with this notice about our privacy practices that explain how, when, and why we use and disclose any more of your PHI than is necessary to accomplish the purpose of the use or disclosure. We are legally required to follow the privacy practices that are described in this notice. However, we reserve the right to change the terms of this notice and our privacy policies at any given time. Any changes will apply to the PHI we currently have in place. Before we make an important change to our policies, we will promptly post a notice in the reception area of our offices. You may also request a copy of this notice from the contact person listed in Section VI, below, at any time.

II. HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION.
We use and disclose health information for many different reasons. For some of these uses or disclosures, we need your specific authorization below, we describe the different categories of our uses and disclosures and give you some examples of each category.

A. Uses and Disclosures Relating to Treatment, Payment, or Health Care Operations. We may use and disclose your PHI for the following reasons:
1. For Treatment: We may disclose your PHI to physicians, nurses, medical students, and other health care personnel who provide you with health care services or who are involved in your care. For example, if you're being treated for a hand injury and need physical therapy, we may disclose your PHI to the physical rehabilitation department in order to coordinate your care.
2. To obtain payment for treatment. We may use and disclose your PHI in order to bill and collect payment for the treatment and services provided to you. For example, we may provide the necessary PHI to your insurance company so that the claim for services provided (i.e. surgery) will be processed.
3. For health care operations. In order to help us run our practice more efficiently and provide better patient care, we may use and disclose your PHI to Business Associates to use or disclose your information to provide a service for our medical practice, such as our credentialing company, who provides with data management on our behalf. 

B. Certain Uses and Disclosures Do Not Require Your Authorization. We may use and disclose your PHI without your authorization for the following reasons:
1. When a disclosure is required by federal, state, or local law, judicial or administrative proceedings, or law enforcement. For example, we make disclosures when a law requires that we report information to government agencies and law enforcement personnel about victims of abuse, neglect, or domestic violence; when dealing with gunshot and other wounds; or when ordered in a judicial or administrative proceeding.
2. For public health activities. For examples, we report information about births, deaths, and various diseases to government officials in charge of collecting that information, and we provide coroners, medical examiners, and funeral directors necessary information relating to an individual's death.
3. For health oversight activities. For example, we will provide information to assist the government when it conducts an investigation or inspection of a health care provider or organization.
4. For purposes of organ donation. If we are notified by an organ procurement organization to assist them in organ, or tissue donation, and transplants.
5. For research purposes: In certain circumstances, we may provide PHI in order to conduct medical research.
6. To avoid harm. In order to avoid a serious threat to the health or safety of a person or the public, we may provide PHI to law enforcement personnel or persons able to prevent or lessen such harm.
7. For specific government functions. We may disclose PHI of military personnel and veterans in certain situations. And we may disclose PHI for national security purposes, such as protecting the president of the United States or conducting intelligence operations.
8. For workers' compensation purposes. We may provide PHI in order to comply with workers compensation laws.
9. Appointment reminders and health-related benefits or services. We may use PHI to provide appointment reminders or give you information about treatment reminders or give you information about treatment alternatives or other health care services we offer. At this time, our office does NOT send out appointment reminders.

C. Two Uses and Disclosures Require You to Have The Opportunity to Object.
1. Patient directories: We may include your name, location in this facility, general condition, and religious affiliation in our patient directory for use by clergy and visitors who ask for you by name unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergencies. WE DO NOT PARTICIPATE IN PATIENT DIRECTORIES! This is for a hospital or nursing home type facility.
2. Disclosures to family, friends, or others. We may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment of your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

D. All Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in Sections III A, B, and C, above, we will ask for your written authorization before using or disclosing any of your PHI. Our office requires a signed authorization for the release of any records to yourself or anyone you designate before we will release the records, for example to your attorney, a family physician, or employer.

III. WHAT RIGHTS YOU HAVE REGARDING YOUR PHI. You have the following rights with respect to your PHI:
A. The Right To Request Limits on Uses and Disclosures of Your PHI. You have the right to ask that we limit how we use and disclose you PHI. We will consider your request but are not legally required to accept it. If we accept your request, we will put any limits in writing and abide by them except in emergency situations. You may not limit the uses and disclosures that we are legally required or allowed to make.
B. The Right to Choose How We Send PHI to You. You have the right to ask that we sent information to you to an alternate address (for example your work address or PO Box rather than your home). We must agree to your request so long as we can easily provide it in the format you request.
C. The Right to See and Get Copies of Your PHI. In most cases, you have the right to look at or get copies of your PHI that we have, but you must make the request in writing. We will respond to your request within 30 days after receiving your written request. Our office charges $30.00 for the first 10 pages, pages 11-60 $1.00 per page, and the pages 61-400 are .50 c a page.
D. The Right to Get a List of the Disclosures We Have Made. You have the right to get a list of instances in which we have disclosed your PHI. The list will not include uses or disclosures that you have already consented to, such as those made for treatment, payment, or health care operations, directly to you, or to your family. This list also won't include uses and disclosures made for national security purposes, to corrections or law enforcement personnel, or before April 14, 2003. We will respond within 60 days of receiving your request. The list we will give you will include disclosures made in the last six years unless you request a shorter time. We will provide you with this list at no charge, but if you make more than one request in the same year, we will charge you $5.00 for each additional request.
E. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI or that a piece of important information is missing, you have the right to request that we correct the existing information or add the missing information You must provide the request and the reason for your request in writing. We will respond within 60 days of the request. We may deny your request in writing if the PHI is (i) correct and complete, (ii) not created by us, (iii) not allowed to be disclosed, (iv) not part of our records, (v) not changing a medical condition or diagnosis. Our written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you do not file one, you have the right to request that your request and our denial be attached to all future disclosures of your PHI. If we approve your request, we will make the change to your PHI, tell you that we have done it, and tell others that need to know about the change to your PHI.

IV. HOW TO COMPLAIN ABOUT OUR PRIVACY PRACTICES If you think that we may have violated your privacy rights, or you disagree with the decision we made about access to your PHI, you may file a complaint with the person listed in Section VI below. You may also send a written complaint to the Secretary of the Department of Health and Human Services. We will take NO retaliatory action against you if you file a complaint about our privacy practices.

V. PERSON TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT OUR PRIVACY PRACTICES If you have any questions about this notice or any complaints about our privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact Jana Allen-Martin, Office Manager, 14887 Southwest Freeway, Sugar Land, Texas 77478, 281/5658099.

VI. EFFECTIVE DATE OF THIS NOTICE This notice went into effect on April 14, 2003.