AFFORDABLE PORTABLE RAMPS NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE READ THIS NOTICE CAREFULLY.
EFFECTIVE April 14, 2003


Our Commitment to Your Privacy


AFFORDABLE PORTABLE RAMPS is dedicated to maintaining the privacy of your identifiable
health information. In conducting our business, we will create records regarding you and the
treatment and services we provide you. We are required by law to maintain the confidentiality of
health information that identifies you. We also are required by law to provide you with this notice
of our legal duties and privacy practices concerning your identifiable health information. By law,
we must follow the terms of the Notice of Privacy Practices that we have in effect at the time.

To summarize, this notice provides you with the following information:
How we may use and disclose your identifiable health information;
Your privacy rights in your identifiable health information;
Our obligations concerning the use and disclosure of your identifiable health information.
The terms of this notice apply to all records containing your identifiable health information that
are created or retained by our organization. We reserve the right to revise or amend our Notice
of Privacy Practice. Any revision or amendment to this notice will be effective for all of your
records our organization has created or maintained in the past, and for any of your records we
may create in the future.

If you have any questions about this notice, please contact AFFORDABLE PORTABLE RAMPS


We may use and disclose your information in the following ways:



Treatment. We may use your identifiable information to provide supplies and services to you.
For example, we ask you to provide us with such information as body weight, height , etc. Many
of the people who work for us may use or disclose your identifiable health information in order
to provide supplies and services to you or to assist others in your treatment. Additionally, we
may disclose your identifiable health information to others who may assist in your care, such as
your physician, therapists, spouse, children or parents.

Payment. We may use and disclose your identifiable health information in order to bill and
collect payment for the services and supplies you may receive from us. For example, we may
contact your health insurer to certify that you are eligible for benefits (and for what range of
benefits), and we may provide your insurer with details regarding your treatment to determine if
your insurer will cover, or pay for your supplies and/or services. We may also use and disclose
your identifiable health information to obtain payment from third parties that may be responsible
for such costs, such as family members. Also, we may use your identifiable health information to
bill you directly for services and supplies.

Health Care Operations. We may use and disclose your identifiable health information to
operate our business. As examples of the ways in which we may use and disclose your health
information for our operations, we may use your health information to evaluate the quality of
care you receive from us, or to conduct cost-management and business planning activities for
our business.

Appointment Reminders. We may use and disclose your identifiable health information to
contact you and remind you of visits/deliveries.

Health-Related Benefits and Services. We may use your identifiable health information to inform
you of health-related benefits or services that may be of interest to you.

Release of Information to Family / Friends. We may release your identifiable health information
to a friend or family member that is helping you pay for your health care, or who assists in
taking care of you.

Disclosures Required By Law. We will use and disclose your identifiable health information
when we are required to do so by federal, state or local laws.


Use and Disclosure of Your Identifiable Health Information in Certain Special Circumstances


The following categories describe unique scenarios in which we may use or disclose your
identifiable health information:
Public Health Risk. We may disclose your identifiable health information to public health
authorities that are authorized by law to collect information for the purpose of:
Maintaining vital records, such as births and deaths;
Reporting child abuse or neglect;
Preventing or controlling disease, injury or disability;
Notifying a person regarding a potential exposure to a communicable disease;
Notifying a person regarding a potential risk for spreading or contracting a disease or condition;
Reporting reactions to drugs or problems with products or devices;
Notifying individuals if a product or device they may be using has been recalled;
Notifying appropriate government agency(ies) and authority(ies) regarding the potential abuse
or neglect of an adult patient (including domestic violence); however, we will only disclose this
information if the patient agrees or we are required or authorized by law to disclose this
information.

Health Oversight Activities. We may disclose your health information to a health oversight
agency for activities authorized by law. Oversight activities can include, for example,
investigations, inspections, audits, surveys, licensure and disciplinary actions; civil,
administrative, and criminal procedures or actions; or other activities necessary for the
government to monitor government programs, compliance with civil rights laws and the health
care system in general.

Lawsuits and Similar Proceedings. We may use and disclose your identifiable health information
in response to a court or administrative order, if you are involved in a lawsuit or similar
proceeding. We also may disclose your identifiable health in response to a discovery request,
subpoena, or other lawful process by another party involved in a dispute, but only if we have
made an effort to inform you of the request or to obtain an order protecting the information the
party has requested.

Law Enforcement. We may release identifiable health information if asked to do so by a law
enforcement official:
Regarding a crime victim in certain situations, if we are unable to obtain the person’s agreement;

Concerning a death we believe might have resulted from criminal conduct;
Regarding criminal conduct in our offices;
In response to a warrant, summons, court order, subpoena, or similar legal process;
To identify/locate a suspect, material witness, fugitive or missing person;
In an emergency, to report a crime (including the location or victim(s) of the crime, or the
description, identity or location of the perpetrator).

Serious Threats to Health or Safety. We may use and disclose your identifiable health
information when necessary to reduce or prevent a serious threat to your health and safety or
the health and safety of another individual or the public. Under these circumstances, we will
only make disclosures to a person or organization able to help prevent the threat.

Military. We may disclose your identifiable health information if you are a member of U.S. or
foreign military forces (including veterans) and if required by the appropriate military command
facilities.

National Security. We may disclose your identifiable health information to federal officials for
intelligence and national security activities authorized by law. We also may disclose your
identifiable health information to federal officials in order to protect the President, other officials
or foreign heads of state, or to conduct investigations.

Inmates. We may disclose your identifiable health information to correctional institutions or law
enforcement officials if you are an inmate or under the custody of a law enforcement official.
Disclosure for these purposes would be necessary: (a) for the institution to provide health care
services to you, (b) for the safety and security of the institution, and/or (c) to protect your health
and safety or the health and safety of other individuals.

Workers’ Compensation. We may release your identifiable health information for workers’
compensation and similar programs.

Coroners, Medical Examiners and Funeral Directors. We may disclose health information to a
coroner or medical examiner. We may also disclose medical information to funeral directors
consistent with applicable law to carry out their duties.

Organ Procurement Organizations. Consistent with applicable law, we may disclose health
information to organ procurement organizations or entities engaged in the procurement,
banking, or the transportation of organs for the purpose of tissue donation and transplant.

Research. We may disclose information to researchers when their research has been approved
by an Institutional Review Board or Privacy Board that has reviewed the research proposal and
established protocols to ensure the privacy of your healthcare information.


Your Rights Regarding Your Identifiable Health Information
Confidential Communications. You have the right to request that we communicate with you
about your health and related issues in a particular manner or at a certain location. For
instance, you may ask that we contact you at home, rather than work. In order to request a type
of confidential communication, you must make a written request to us, specifying the requested
method of contact or location where you wish to be contacted. We will accommodate
reasonable requests. You do not need to give a reason for your request.

Requesting Restrictions. You have the right to request a restriction in our use or disclosure of
your identifiable health information for treatment, payment or health care operations.
Additionally, you have the right to request we limit our disclosure of your identifiable health care
information to individuals involved in your care or the payment for your care, such as family
members and friends. We are not required to agree to your request; however, if we do agree,
we are bound by our agreement except when otherwise required by law, in emergencies, or
when the information is necessary to treat you. In order to request a restriction in our use or
disclosure of your identifiable health information, you must make your request in writing to us.
Your request must describe in clear and concise fashion: (a) the information you wish
restricted; (b) whether you are requesting to limit our use, disclosure or both; and (c) to whom
you want the limits to apply.

Inspection and Copies. You have the right to inspect and obtain a copy of the identifiable health
information that may be used to make decisions about you, including patient medical records
and billing records, but not including psychotherapy notes. You must submit your request in
writing to us in order to inspect and/or obtain a copy of your identifiable health information. We
may charge a fee for the costs of copying, mailing, labor and supplies associated with your
request. We may deny your request to inspect and/or copy in certain limited circumstances;
however, you may request a review of our denial. Reviews will be conducted by another
licensed health care professional chosen by us.

Amendment. You may ask us to amend your health information if you believe it to be incorrect
or incomplete, and you may request an amendment for as long as the information is kept by or
for us. To request an amendment, your request must be made in and submitted to us in writing.
You must provide us with a reason that supports your request for amendment. We will deny
your request if you fail to submit your request (and the reason supporting your request) in
writing. Also, we may deny your request if you ask us to amend information that is: (a) accurate
and correct; (b) not part of the identifiable health information kept by or for us; (c) not part of
the identifiable health information which you would be permitted to inspect and copy; (d) not
created by us, unless the individual or entity that created the information is not available to
amend the information.

Accounting of Disclosures. All of our patients have the right to request an “accounting of
disclosures.” An “accounting of disclosures” is a list of certain disclosures we have made of
your identifiable health information. In order to obtain an accounting of disclosures, you must
submit your request in writing to our office. All requests for an “accounting of disclosures” must
state a time period which may not be longer than six years and may not include dates before
April 14, 2003. The first list you request within a 12 month period is free of charge, but we may
charge you for additional lists within the same 12 month period. We will notify you of the cost
involved with additional requests, and you may withdraw your request before you incur any
costs.

Right to a Paper Copy of This Notice. You are entitled to receive a paper copy of our Notice of
Privacy Practices. You may ask us to give you a copy of this notice at any time. To obtain a
paper copy of this notice, contact our office.

Right to File a Complaint. If you believe your privacy rights have been violated, you may file a
complaint with us or with the Office of Civil Rights. All complaints must be in writing. You will not
be penalized for filing a complaint.

Right to Provide an Authorization for Other Uses and Disclosures. We will obtain your written
authorization for uses and disclosures that are not identified by this notice or permitted by
applicable law. Any authorization you provide to us regarding the use and disclosure of your
identifiable health information may be revoked at any time in writing. After you revoke your
authorization, we will no longer use or disclose your identifiable health information for the
reasons described in the authorization. Please note, we are required to retain records of your
care.
PRIVACY STATEMENT