Notice of Privacy Practices

Effective Date: 03/31/2025
This notice describes how medical information about you may be used and disclosed and how you can access this information.
Please review it carefully.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and our responsibilities.

You have the right to:

• Get a copy of your medical records
  You can request to see or get an electronic or paper copy of your medical record and other health information we have about you. We’ll provide it within 30 days and may charge a reasonable, cost-based fee.

• Ask us to correct your medical records
  If you believe your records are incorrect or incomplete, you can request a correction. We may deny your request, but we’ll explain why in writing within 60 days.

• Request confidential communications
  You can ask us to contact you in specific ways (e.g., home or office phone) or to send mail to a different address. We will accommodate reasonable requests.

• Limit what we use or share
  You may ask us not to use or share certain health information for treatment, payment, or our operations. While we are not required to agree, we will honor your request if possible. If you pay out-of-pocket in full for a service, you can request that we not share information about it with your health insurer.

• Get a list of who we’ve shared your information with
  You can request a list of the times we’ve shared your health information in the past six years, who we shared it with, and why. One request per year is free; additional requests may incur a reasonable fee.

• Get a copy of this privacy notice
  You can request a paper copy of this notice at any time.

• Choose someone to act for you
  If you have a medical power of attorney or legal guardian, that person may exercise your rights. We will confirm their authority before taking any action.

• File a complaint if you feel your rights are violated
  You may file a complaint with us or with the U.S. Department of Health and Human Services at:
  200 Independence Avenue, S.W., Washington, D.C. 20201
  Phone: 1-877-696-6775
  Online: www.hhs.gov/ocr/privacy/hipaa/complaints
  We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your preferences about how we share it.

You have both the right and choice to tell us to:

• Share information with family or friends involved in your care

• Share information in disaster relief situations

• Include your information in a hospital directory

• Contact you for fundraising efforts

If you are unable to tell us your preferences (e.g., unconscious), we may share your information if we believe it is in your best interest or to reduce a serious and imminent threat to health or safety.

We will never share your information for:

• Marketing purposes

• Sale of your information

• Most sharing of psychotherapy notes unless you give us written permission.

You can opt out of fundraising communications at any time.

Our Uses and Disclosures

We typically use or share your health information in the following ways:

• Treating you
  We can use your health information and share it with other professionals involved in your care.
  Example: A doctor treating you for an injury consults with another doctor about your condition.

• Running our organization
  We use your information to manage your care and improve our services.
  Example: We use information to manage your treatment and send appointment reminders.

• Billing for your services
  We share information with insurers or other entities to bill and receive payment.
  Example: We send your information to your insurance company for reimbursement.

Other Ways We May Use or Share Your Information

We are permitted or required to share your information in ways that contribute to public health, research, and legal matters. These include:

• Public health and safety
  To prevent disease, report adverse drug reactions, respond to product recalls, report abuse or neglect, and reduce threats to safety.

• Research purposes
  Under certain conditions, we may use your information for health research.

• Compliance with the law
  When required by federal or state laws, including sharing with the Department of Health and Human Services.

• Organ and tissue donation requests
  We can share information with organ procurement organizations.

• Medical examiners and funeral directors
  To help carry out their duties after an individual dies.

• Workers’ compensation, law enforcement, and other government requests
  Including national security, presidential protection, and law enforcement purposes.

• Legal proceedings
  In response to court orders, subpoenas, or administrative requests.

Our Responsibilities

• We are required by law to protect your health information.

• We will notify you promptly if a breach occurs that may compromise your information.

• We must follow the privacy practices described in this notice.

• We will not share your information unless you authorize us in writing, except as described above.

• You may revoke your authorization at any time in writing.

For more information, visit: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

Changes to This Notice

We reserve the right to change the terms of this notice. Any updates will apply to all information we have about you and will be available in our office and on our website.

This Notice of Privacy Practices applies to the following organizations:
Rolseth Drug, Co. DBA Lindstrom Thrifty White