Personalized Nutrition, Inc.

Notice of Privacy Practices

6/1/07

Keeping our client’s personal health information secure is a top priority for us at Personalized Nutrition, Inc. While information is the cornerstone of our ability to provide superior nutrition services, our most important asset is our client’s trust. This notice tells you how we collect, handle, and disclose personal health information about you. If you want to limit our disclosing of this information, please submit your wishes to us in writing.

Our Policies and Practices to Protect Your Personal Health Information

We protect personal health information we collect about you by maintaining physical, electronic, and procedural safeguards that meet or exceed applicable law.

Protected Health Information We Collect and May Disclose

The protected health information we collect about you comes from the following sources:

  • Information received from your physician or other healthcare provider.
  • Information we receive from you while making appointment times, providing nutrition counseling and services and on enrollment forms, assessment surveys, or other forms.
  • Information we receive from other sources such as caregiver, insurer, employer and other third parties.

We may disclose your protected health information to your insurance company, your doctor(s) office and other healthcare professionals as indicated by you. We may disclose your protected health information to a covered entity that intends to contact you for appointment reminders, as long as this information is directly related to your individual nutrition-related care. Please let us know your contact number and/or email address so we can contact you as needed.

Your protected health information may be disclosed in the form of a “limited data set” for research, public health, and health care operations. A “limited data set” does not contain any direct identifiers of individuals (e.g. should not include name, address, phone number, social security number, medical number, etc.), but may contain any other demographic or health information needed for research public health or health care operations purposes.

 

If necessary to abide by law, we will change the terms of this notice, in writing on our website and at your next appointment. Our Privacy Officer is Cathie Ostrowski.

Personalized Nutrition, Inc.

[email protected]      phone (919) 367-0677      fax (919) 367-0818     
P.O. Box 1298, Apex, NC 27502-2005

 

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