Notice of Privacy Practices

The privacy of your medical information is important to us. We understand that your medical information is personal, and we are committed to protecting it. We create a record of the care and services you receive at Cortex Migraine. We need this record to provide you with quality care and to comply with certain legal requirements. This notice tells you about the ways we may use and share your medical information, and describes your rights and our duties regarding it.

The law requires us to:

• Keep your medical information private.
• Give you this notice describing our legal duties, privacy practices, and your rights regarding your medical information.
• Follow the terms of the current notice.

We have the right to change our privacy practices and the terms of this notice at any time, provided the changes are permitted by law. Changes apply to all medical information we keep, including information created or received before the change. Before we make an important change, we will update this notice and make the new notice available on request.

We will not use or disclose your medical information for any purpose not described below without your specific written authorization. Any authorization you provide may be revoked at any time by writing to us at the address at the end of this notice.

For treatment. We may use your medical information to provide you with medical treatment or services. We may disclose it to doctors, nurses, technicians, and others who take care of you, and to your other health care providers to assist them in treating you.

For payment. We may use and disclose your medical information for payment purposes — for example, a bill sent to you or your insurance company may include medical information.

For health care operations. We may use and disclose your medical information for our operations — measuring and improving quality, evaluating staff performance, training, and obtaining the accreditation, licenses, and credentials we need to serve you.

Additional uses. Unless you object, we may use or disclose your information to: notify or help notify a family member, personal representative, or other person responsible for your care about your location and general condition; assist disaster-relief efforts; and include you in our facility directory so people who ask for you by name can be told you are here and your general condition. We may contact you for fundraising, and you may opt out of those communications at any time.

Research in limited circumstances. We may use your information for research approved by a review board that has established protocols to protect your privacy.

As required by law. We may disclose your information when required by federal or state law, including to public health authorities (reporting disease or injuries), to report suspected abuse or neglect, to health oversight agencies for audits and investigations, for law-enforcement purposes as permitted by law, to coroners, medical examiners, and funeral directors, and for organ donation purposes. Subject to requirements, we may disclose information for military and veterans' activities, national security, and protective services.

If we receive substance use disorder treatment records created by a federally assisted program, we generally may only use or disclose those records in accordance with the written consent you provided to that program.

• Access. You have the right to look at or get a copy of your medical record, with limited exceptions. To exercise this right, contact us using the information below.
• Disclosure accounting. You have the right to receive a list of certain disclosures we have made of your medical information in the six years before your request.
• Restrictions. You have the right to request restrictions on how we use or disclose your information for treatment, payment, or operations. We are not required to agree to a restriction, except that if you pay in full out of pocket for a service, we must honor a request not to disclose information about that service to your health plan.
• Confidential communications. You have the right to request that we communicate with you about your care in a certain way or at a certain location (for example, only at a certain phone number). We will accommodate reasonable requests.
• Amendment. If you believe information in your record is incorrect, you may request an amendment. We may deny the request under certain circumstances and will explain why.
• Paper copy. You have the right to receive a paper copy of this notice at any time, even if you agreed to receive it electronically.

If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below, or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.

Privacy questions or complaints: call (833) 426-7839 or write to Cortex Migraine, 2502 S Union Ave, Suite 210, Tacoma, WA 98405.