Family Tree Clinic

Patient Privacy Policy

We take your privacy seriously

Your Health Record
Each time you visit a health care provider a record of your visit is made. Usually this record has your symptoms, exam and test results, diagnoses, treatment, and a plan for future care. This information is called your medical record. It serves as a:

Understanding what is in your record and how your health information is used helps you to:

We will not use or give out your health information without your permission, except as described in this Notice.

Everyday Use of Your Private Information
We will use your health information for treatment. For example: Information the nurse, provider, or other member of your healthcare team gets about you will be put in your record and used to decide the best course of treatment for you.

We will use your health information for payment.
For example: If you give the clinic permission, a bill will be sent to your insurance. If you are paying for services yourself, a bill may be sent to the address you provide us. The information on or with the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

We will use your health information to improve the quality of patient care.
For example: Members of the clinical staff or the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used to improve the quality and effectiveness of the health care and services we provide.

We will share your health information with our business associates.
There are some services we provide through business associates. One example is sending a test to a laboratory. We may disclose your health information to our business associate so that they can do the job we have asked them to do. We require all business associates to follow privacy standards and protect your health information.

We will use your personal information to communicate with you.
If you give us your phone number and give us permission to contact you, we may call to remind you of appointments. We may contact you if a problem arises with your health care.You have the right to request restrictions on the use and disclosure of your private information. We have the right to decline this request. Please tell the Front Desk staff how you would like your information restricted.

We may contact you as part of a fundraising effort.

Situations Where We Need to Disclose (Release) Your Information
These are examples of times we may have to disclose your information without your permission:
Required By Law. We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.
Public Health. As required by law, we may disclose your health information to public health or legal authorities that have the goal of preventing or controlling disease, injury, or disability. This includes some positive sexually transmitted infection test results.
Food and Drug Administration (FDA). We may need to report problems with products. The FDA may also need to have information if there are product recalls, repairs, or replacements.
Workers Compensation. We may disclose health information when necessary to follow laws relating to workers compensation or other similar programs established by law.

Your Rights to Your Health Information
Although your health record belongs to the health care facility that put it together, the information in it belongs to you. You have the right to:

Our Responsibilities
The Family Tree Clinic is required to:

We reserve the right to change our privacy practices for all protected health information we keep. If our Privacy Notice changes, we will post the current copy in the lobby and offer you a copy when you come to the clinic. You may also ask for a current copy at any time.

If You Have Questions or Complaints
If you believe your privacy rights have been violated, please speak to the Clinic Director. Phone: 612-473-0800.
You may also file a complaint with the Secretary of Health and Human Services, Hubert H. Humphrey Building, 200 Independence Ave SW, Washington, D.C., 20201. Phone: 1-877-696-6775
You will not be treated badly if you make a complaint.