THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION

For our patients: as regards to The Health Insurance Portability and Accountability Act (HIPPA)
This is a summary of our office policy. We will provide you with the detailed policy statement if you wish. Our staff is trained in preserving your privacy for your protected health information. We will only share this information as necessary for the purpose of treatment, payment, and the administrative operation of the office. If we need to share your information for other reasons (i.e. education or research) we will discuss the situation with you and obtain a written consent. Since we are a small office and staff is cross trained, each staff member will have access to your records. Any breach of this privacy policy will involve appropriate sanctions. If there is any problem concerning your privacy, please file a complaint with Dr. Hai T. Pham (as the HIPPA contact officer) here in the office, either by mail or email. As noted in the detailed policy, no retaliatory action will be taken against patients who exercise their rights under HIPPA.

I have received the Notice of Privacy Practices and have been provided an opportunity to review it.

In general, the HIPPA privacy rule gives individuals the right to request a restriction on uses and disclosures of their personal health information (PHI). The individual is also provided the right to request confidential communications or that a communication of PHI be made by alternative means, such as sending correspondence to the individual's office instead of the individual's home.

14671 SW Millikan Way
Beaverton, OR 97006
Phone: 503-644-4749
Fax: 503-747-6192

3075 SE Century Blvd Suite #109
Hillsboro, OR 97123
Phone: 503-642-1535
Fax: 503-649-2286

2375 SW Cedar Hills Blvd
Portland, OR 97225
Phone: 971-713-3899
Fax: 503-747-6192