SUMMARY OF THE NOTICE OF PRIVACY
JORGE A MARTINEZ, MD, PA
1615 12th Ave Rd, Ste B
Nampa, ID 83686
We have always been committed to maintaining the privacy of your personal health information. The Federal government now requires that we notify you about how we use and disclose your health information. We are required to allow you to review our Notice of Privacy. Below is a summary of our Notice. Please read it carefully.
1. We may use and disclose your medical records only for treatment, payment or operations. Our Notice includes those parties with whom we reserve the right to exchange information. Any other uses and disclosures will be made only with your written authorization as described in our Notice of Privacy.
2. We may use your health information, as well as information from other patients, to help us become more efficient and improve
our quality of care. This information is for internal use only and will not be disclosed without your prior written consent
3. We may contact you by phone or mail to remind you of your appointments unless you notify us in writing that you do not want
us to contact you. You may also restrict how we contact you. We will try to accommodate all reasonable requests.
4. We are required to disclose your health information to certain federal, state or law enforcement agencies.
5. You may obtain copies of your records. There may be a nominal charge for these copies. You may examine your records. We may
request that you make an appointment to review you records. You may request amendments to your records. We reserve the right to deny your request for amendment but will record your request.
6. We will not sell lists of patients for advertising or for any other reason.
7. We are required to notify you of any changes in our privacy policies and procedures that will affect you.
8. If you believe your rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Welfare. You will not be penalized for your complaint.
9. You have the right to discuss information in the Summary with our Business Administrator during normal business hours. You have the right to receive a copy of the entire Notice of Privacy upon request.