I understand that under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), I have certain rights to privacy regarding my protected health information. The information obtained by the office of Dr. Vivian Asamoah can and
- Conduct, plan, and direct treatment
- Obtain payment from third-party payers
- Conduct normal healthcare operations such as quality assurance
I have had the opportunity to read and understand the Notice of Privacy Practices containing a more complete description of the uses and disclosures of my health information. I also understand the office of Dr. Vivian Asamoah has the right to amend this notice and that I am entitled to an updated copy of this notice if requested. I understand I may request in writing to restrict how my health information is used or disclosed by the office of Dr. Vivian Asamoah to carry out treatment and healthcare operations. However, I understand that the facility may not accept these requested restrictions, but if accepted must abide by treatment. I understand that I have the right to review and copy my health information and request a change to any information that I believe is not a complete list of each disclosure of my protected health information.