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
· To a prosecuting officer of the court if you are being prosecuted under Virginia
· 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
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
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.