Notice of Privacy Practices
I. We are legally required to:
A. Maintain the privacy of your private health information (PHI).
B. Provide you with a written notice that outlines your rights relating to your private health information.
C. To assist you in designating how your private health information will be used & to whom it may be disclosed.
II. We do not need your authorization to release your PHI if it is released to:
A. Provide treatment to you.
B. Obtain payment for having treated you.
C. Operate this facility.
D. Any agency or authority that has a right to demand our PHI by law.
III. You have the following rights regarding your PHI:
A. Inspect and copy your PHI. To copy your PHI, there will be a fee.
B. Amend your PHI.
C. To restrict certain uses and releases of information of your PHI.
Complaints: If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Federal Department of Health & Human Services. We will not retaliate against you for filing a complaint.
We reserve the right to change our privacy practices in the future.
**You must make any requests in writing**
130 E. Virginia St.
Gunnison, CO 81230
Phone: (970) 641-2241
Fax: (970) 641-1268