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Notice of Privacy Practices This notice describes how your protected health information may be used and disclosed and how you can get access to this information. Please review it carefully. Effective Date: April 14, 2003 Who Will Follow This Notice All of the employees, staff, including medical and psychiatry staff, as well as other personnel of the New York Gracie Square Hospital, Inc. (The "Hospital"), will follow these privacy practices. About This Notice This notice will tell you about the ways we may use and disclose your protected health information. We also describe your rights and certain obligations we have regarding the use and disclosure of protected health information. We are required by law to make sure that protected health information that identifies you is kept private; give you this notice of our legal duties and privacy practices with respect to your protected health information; and follow the terms of the notice that is currently in effect. Changes to This Notice We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for your protected health information we already have as well as any information we receive in the future. We will post copies of the current Notice in the Hospital. The Notice will contain on the first page, the effective date. In addition, each time you register at or are admitted to the Hospital for treatment, we will make available copies of the current Notice. Any revisions to our Notice will also be posted on our website. Complaints If you believe your privacy rights have been violated, you may file a complaint with the Hospital or with the Secretary of the Department of Health and Human services. To file a complaint with the Hospital, please write to Patient Relations Department, see address on the first page of this Notice. You will not be penalized for filing a complaint. Other Uses and Disclosures of Protected Health Information Other uses and disclosures of protected health information not covered by this Notice or the laws that apply to us will be made only with your written authorization, on a Hospital authorization form. If you provide us authorization to use or disclose your protected health information, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose your protected health information for the reasons covered by your written authorization. However, we may continue to use or disclose that information to the extent we have relied on your authorization. You also understand that we are unable to take back any disclosures we have already made with your authorization, and that we are required to retain our records of the treatment that we provided to you. Please review the links below contained within this Notice of Privacy Practices, |
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For further information Contact Us at Gracie Square Hospital
212-988-4400 or Email Us at info@nygsh.org