Ø Genetic Information. Except in certain cases (such as a paternity test for a court proceeding, anonymous research, newborn screening requirements, or pursuant to a court order), we will obtain your special written consent prior to obtaining or retaining your genetic information (for example, your DNA karyotype), or using or disclosing your genetic information for treatment, payment or health care operations purposes. We may use or disclose your genetic information for any other reason only when your authorization expressly refers to your genetic information or when disclosure is permitted under Virginia State law (including, for example, when disclosure is necessary for the purposes of a criminal investigation, to determine paternity, newborn screening, identifying your body or as otherwise authorized by a court order).

Ø Sexually Transmitted Disease Information. Your authorization must expressly refer to your sexually transmitted disease information in order to permit us to disclose any information identifying you as having or being suspected of having a sexually transmitted disease. However, there are certain purposes for which we may disclose your sexually transmitted disease information, without obtaining your authorization including:

· To a prosecuting officer of the court if you are being prosecuted under Virginia State law,

· To the Virginia State Department of Health, or

· To your physician or a health authority, such as the local board of health.

Your physician or a health authority may further disclose your sexually transmitted disease information if he/she/it deems it necessary in order to protect the health or welfare of you, your family or the public. Under Virginia State law, we may also grant access to your sexually transmitted disease information upon the request of a person (or his/her insurance carrier) against whom you have commenced a lawsuit for compensation or damages for your personal injuries.

Ø Tuberculosis Information. Your authorization must expressly refer to your tuberculosis information in order to permit us to disclose any information identifying you as having tuberculosis or refusing/failing to submit to a tuberculosis test if you are suspected of having tuberculosis or are in close contact to a person with tuberculosis. However, there are certain purposes for which we may disclose your tuberculosis information, without obtaining your authorization, including for research purposes under certain conditions, pursuant to a valid court order, or when the Commissioner of the Virginia State Department of Health (or his/her designee) determines that such disclosure is necessary to enforce public health laws to protect the life or health of a named person.

Ø Psychotherapy Notes. We will obtain your authorization to disclose any psychotherapy notes as defined by law about you except under certain circumstances as permitted by regulation.

YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION

Ø Right to Request Additional Restrictions. You may request restrictions on our use and disclosure of your PHI:

· For treatment, payment and health care operations,

· To individuals (such as a family member, other relative, close personal friend or any other person identified by you) involved with your care or with payment related to your care, or

· To notify or assist in the notification of such individuals regarding your location and general condition.

While we will consider all requests for additional restrictions carefully, we are not required to agree to a requested restriction. If you wish to request additional restrictions, please obtain a request form from our Privacy Office and submit the completed form to the Privacy Officer. We will send you a written request within thirty (30) days.

Ø Right to Receive Confidential Communications. You may request, and we will accommodate any reasonable written request, for you to receive your PHI by alternative means of communication or at alternative locations.

Ø Right to Revoke Your Authorization. You may revoke your authorization, except to the extent that we have taken action in reliance upon it, by delivering a written revocation statement to the Privacy Officer identified below. A form of Written Revocation is available upon request from the Privacy Officer.