Privacy Policy

Last updated January 5, 2014.

Please read this policy, and sign the Acknowledgement of Receipt of Notice of Privacy Practices, before your first appointment.

You do not need to print out this privacy policy, but if you wish to do so you can download it in printable format here: Word - PDF

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. Dr. Alexander is very committed to protecting your health information. Please Review Carefully.

Dr. Alexander respects your privacy. We (Dr. Alexander and her assistants) understand that your personal health information is very sensitive. The law protects the privacy of the health information we create and obtain in providing care and services to you. Your protected health information includes your symptoms, test results, diagnoses, treatment, health information from other providers, and billing and payment information related to these services.

We will not use or disclose your health information to others without your authorization, except as described in this Notice of Privacy Practices (“Notice”), or as required by law.


Your Protected Health Information

Protected Health Information is information that individually identifies you and that we create or get from you or from another health care provider, health plan, your employer, or a health care clearinghouse and that relates to: (1) your past, present, or future physical or mental health or conditions (2) the provision of health care to you, or (3) the past, present, or future payment for your health care.

Your Health Information Rights

The health and billing records we create and store are the property of Dr. Alexander. The protected health information in it, however, generally belongs to you. You have a right to:

Our Responsibilities:

We Are Required to:

We reserve the right to change our privacy practices and the terms of this Notice, and to make the new privacy practices and notice provisions effective for all of the protected health information we maintain. If we make material changes, we will update and make available to you the revised Notice upon request. You may receive the most recent copy of this Notice by calling and asking for it or by visiting Dr. Alexander’s office to pick one up.

To Ask For Help or To Make a Complaint:

If you have questions, want more information, or want to report a problem about the handling of your protected health information, please inform Dr. Alexander or her scheduling assistant.

If you believe your privacy rights have been violated, you may discuss your concerns with Dr. Alexander or her scheduling assistant. You may also deliver a written complaint to Dr. Alexander. You may also file a complaint with the Department of Health and Human Services Office for Civil Rights (OCR).

We respect your right to file a complaint with us or with the OCR. There will be no retaliation against you if you make a complaint.

How We May Use And Disclose Your Protected Health Information Without Your Permission:

Under the law, we may use or disclose your protected health information under certain circumstances without your permission. The following categories describe the different ways we may use and disclose your protected health information without your permission. For each category, we will explain what we mean and give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose health information will fall within one of the categories.

Below are examples of uses and disclosures of protected health information for treatment, payment, and health care operations.

For Treatment:

For Payment:

For Healthcare Operations:

Some of the other ways that we may use or disclose your Protected Health Information without your authorization are as follows:

Uses And Disclosures That Require Your Authorization.

Certain uses and disclosures of your health information require your written authorization. The following list contains the types of uses and disclosures that require your written authorization:

Minors - A person under 18 years of age.

Certain Protected Health Information of minor children cannot be disclosed to their parents or guardians without the minor’s written consent, if information is considered a Protected Health Class by Washington State law.

These are the Protected Health Classes:

In addition, other uses and disclosures of your health information that are not described in this Notice will be made only with your written authorization. You have the right to cancel prior authorizations for these uses and disclosures of your health information by giving us a written revocation. Your revocation does not affect information that has already been released. It also does not affect any action taken before we receive the revocation. Sometimes, you cannot cancel an authorization if its purpose was to obtain insurance.