Terms and Conditions of Use
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Please take a few minutes to read over the following information carefully because by using our web sites you automatically agree to abide by the terms and conditions and privacy practices set forth below. Use of our web sites is subject to your compliance and agreement with these terms and conditions and privacy practices. Naturally, if you do not agree, please do not use our web sites. We will periodically make changes to these web sites and these terms and conditions of use and these privacy practices and your continued use of these sites will mean you accept those changes and will be bound by them.
Disclaimer of Liability and Disclaimer of Medical or Legal Advice
The contents of Friendly Foot Care, PC web sites (staging.friendlyfootcare.com and it’s blog America’s Podiatrist (www.Americas Podiatrist.com) website, such as text (including articles, posts, answers to questions, e-mail communications, other internet or web-based communications and comments), graphics, images, information, links, pointers, hyperlinks, audio recordings and videos are for your personal informational purposes only. Any Friendly Foot Care or America’s Podiatrist website or e-mail communications (including communication through the Patient Survey and the Appointment Scheduling pages) do not constitute medical advice, recommendations, diagnosis or treatment and these do not constitute or initiate a doctor-patient relationship. These means of communication are not secure. Further, any e-mail or telephone communications that are in response to or in follow-up to communication initiated through these websites (including the Patient Survey and the Appointment Scheduling pages), do not constitute medical advice, recommendations, diagnosis or treatment, and these communications do not constitute a doctor-patient relationship. No medical care, diagnosis or professional recommendations are done via e-mail, internet or other web-based method.
These websites and related communications (via internet, e-mail. regular mail, automated reply, or telephone) are not a substitute for professional medical care or diagnosis, and they should not be considered medical care or constitute a doctor-patient relationship. These web sites do not provide medical care, advice, diagnosis, treatment or legal advice. None of the information on this website or the America’s Podiatrist website is intended to invite, induce or encourage any person to make a medical, financial, legal, fitness or health decision.
If you think that you may have a medical emergency, go to your nearest hospital emergency room or call 911 immediately. If you have or suspect you may have a health problem, you should consult your health care provider. Never disregard professional medical advice or delay in seeking it because of something you have read on the Friendly Foot Care, PC or America’s Podiatrist web sites.
You should also ask your physician or other qualified healthcare provider to assist you in interpreting any information in these web sites or in the linked web sites, or in applying the information on these web sites to your individual case. Always consult with your physician PRIOR to implementing or applying any information, activities, or recommendations on the Friendly Foot Care or America’s Podiatrist websites.
This website, Friendly Foot Care PC, Dr. Nirenberg and any representatives, employees, or associates of Dr. Nirenberg or Friendly Foot Care PC, are not attorneys, lawyers, or legal advisers, and none of these entities provide legal advice. The information provided by Friendly Foot Care PC this website and Dr. Nirenberg (and his representatives and associates) is not legal advice. No attorney-client relationship is established. Dr. Nirenberg, Friendly Foot Care PC and representatives of these entities have the right to refuse to review a malpractice case at their discretion, with or without notice. Further, their review is a non-legal opinion and should not be relied on as legal or medical advice. You should not act or rely on any information at this web site, Dr. Nirenberg, Friendly Foot Care or representatives of these entities without seeking the advice of an attorney.
No responsibility is assumed for the accuracy or timeliness of any information on this website or information provided by Dr. Nirenberg, his representatives or from Friendly Foot Care. The application of any law referenced, to a particular transaction or dispute can vary greatly depending upon the factors of that situation. You are advised to obtain advice from a licensed attorney who can adequately assess your particular situation.
The information and materials presented on the Friendly Foot Care, PC and America’s Podiatrist web sites are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information on our web sites and information that your physician has told you, it is more likely that your physician is correct. He or she has the benefit of knowing you, your medical history and your medical problems.
Individual results for treatments, recommendations and procedures discussed on this website and America’s Podiatrist website vary widely. A treatment, recommendation or procedure that benefited one person may not work for another person or could cause harm to another person. Treatments, recommendations and procedures have risks and the possibility for complications and/or untoward effects and harmful consequences. No treatment, recommendation or procedure is suitable for everyone. No treatment, recommendation or procedure works as intended for every person. Always discuss any treatment, recommendation or procedure on this website or America’s Podiatrist website with your physician BEFORE implementing any treatment, recommendation or procedure.
The Friendly Foot Care, PC and America’s Podiatrist web sites or any other party, person or entity providing information, comments, links or other material on the Friendly Foot Care, PC or America’s Podiatrist web sites does not make any warranty expressed or implied, including warranties of merchantability, and does not assume any legal liability for the accuracy, completeness or usefulness of any information, products or links from these web sites. Nothing on the web sites constitutes medical advice, care, treatment, or diagnosis. No physician-doctor relationship established through the use of the America’s Podiatrist or Friendly Foot Care, PC web sites.
In addition, the above mentioned assumes no damages of any kind including but not limited to punitive and compensatory damages, indirect, loss of use, loss of data, loss of income or profit, loss of or damage to property, claims of third parties or other losses of any kind. In no event shall Friendly Foot Care, PC nor any of its employees, officers, directors, agents, content providers, locensors, be liable for any direct or indirect, consequential, special, compensatory damages, or incidenal, or punative damages arising out of your access to, or use of this website or America’s Podiatrist website.
Friendly Foot Care, PC and Dr. Nirenberg disclaims any liability whatsoever for any documentation, information, programs, software, links, products or other material which is or may become a part of the web sites. Friendly Foot Care, PC and Dr. Nirenberg does not warrant or guarantee that the information will not be offensive to any user. Users to the Friendly Foot Care, PC and America’s Podiatrist sites are hereby put on notice that by accessing and using the web sites, user assumes the risk that the information and documentation contained in the web sites may be offensive and/or may not meet the needs and requirements of the user or may be inaccurate.
No national, state or local podiatry organization is affiliated with or has any influence on the content of the Friendly Foot Care or America’s Podiatrist websites.Member organizations listed on this website and affiliations listed on this website may change, with or without notice. In regard to the APMA (American Podiatric Medical Association) and IPMA, to clarify, these are organizations of which Dr. Nirenberg is a member and not the company Friendly Foot Care, PC.
Confidential and Proprietary Information
Friendly Foot Care, PC does not want to receive confidential or proprietary information from you through the Friendly Foot Care, PC web sites. Please note that any information or material sent to Friendly Foot Care, PC and Dr. Nirenberg through the Friendly Foot Care, PC web sites will be deemed NOT to be confidential and is not secure. This includes any communications made by you to schedule an appointment with our office and any related or unrelated e-mail communications. By sending Friendly Foot Care, PC or Dr. Nirenberg or America’s Podiatrist website any information or material, you grant Friendly Foot Care, PC an unrestricted, irrevocable, world-wide, royalty-free license to use, reproduce, display, perform, modify, transmit and distribute those materials or information, and you also agree that Friendly Foot Care, PC and Dr. Nirenberg are free to use any ideas, concepts, know-how or techniques that you send us for any purpose.
You can browse http://friendlyfootcare.com and http://AmericasPodiatrist.com anonymously without identifying yourself during your visit. We will obtain information that personally identifies you when you specifically choose to provide it. For example, during your visits to our web site(s), you may request information or contact us.
“Cookies” are small amounts of data that a website can send to a web browser on a visitor’s computer. The cookie is stored on a visitor’s computer. A cookie may enable the site holder to track how a visitor navigates through its site and the areas in which they show interest. This is similar to a traffic report: it tracks trends and behaviors, but does not identify individuals. A cookie may also be used to authentic the user and the machine accessing the site. Information gathered from using cookies may include date and time of visits, pages viewed, time spent at the site, the site visited just before and just after the site, or general information about the machine used to access the site.
These tracking pixels (also known as action tags, web beacons, or transparent GIF files) and other similar tracking technologies may be used to collect and store information about user visits, such as the user’s anonymous cookie ID, page visits and duration, and the specific ad or link(s) that the user clicked on to visit the site. No personally identifiable information is stored on these cookies or web pixels. This user activity information is reported to us in aggregate and is anonymous. We use this information in aggregate to understand, for example, the effectiveness of our advertising and marketing.
If you choose to send us an e-mail message, we may retain the content of the e-mail, your e-mail address, and our response in order to service your needs. Whenever you provide to us or we otherwise obtain your e-mail address, we may use that e-mail address to send you messages related to your accounts or services or other products or services that may be available to you.
Copyright and Trademark Notice
Copyright law protects material on these web sites. The terms “Friendly Foot Care”, “Your Feet Deserve a Hand” “It All Starts With Caring” and the Friendly Foot Care logo are Registered Service Marks of Friendly Foot Care, PC.
Any logos, trademarks, service marks, product names or named features are assumed to be the property of their respective owners, and are used only for reference. There is no implied endorsement from these associations, organizations or their owners and no implied endorsement from Friendly Foot Care to these associations, organizations or their owners in the use of these terms, products or services.
Any reproduction of artwork, material, photographs or information appearing on the pages of these web sites is prohibited without prior written consent from Dr. Michael Nirenberg. This website (FriendlyFootCare.com) and the America’s Podiatrist blog is for your personal and non-commercial, non-economic use only. You are not allowed to modify, copy, send, print, communicate, distribute, transmit, share, display, perform, reproduce, publish, license, create derivative works from, transfer, or sell any information, products or services obtained from any Friendly Foot Care website or related website without the written authorization of Dr. Nirenberg. All content on these web sites provided by third parties is subject to any applicable terms and conditions provided by that third party, and you agree to be bound by those terms and conditions.
Notice of Copyright Infringement
We intend that all Website content respect the copyright and other proprietary rights of third parties. If at any time You believe that any of our Website Content infringes your copyrighted material, then You may request the content be removed from our Website in accordance with the Copyright Act, 17 U.S.C. § 512(c)(3) and procedures described below.
You must send a notice that complies with the Copyright Act (“Notice”) to:
Friendly Foot Care, PC
50 W. 94th Place
Crown Point, IN 46307
Your Notice must be in writing and must include:
- A physical or electronic signature of the person authorized to act on behalf of the owner of an exclusive right that is allegedly infringed;
- Identification of the copyrighted work claimed to have been infringed, or, if multiple copyrighted works are covered by a single notification, a representative list of such works;
- Identification of the material that is claimed to be infringing or to be the subject of infringing activity and that is to be removed or access to which is to be disabled, and information reasonably sufficient to permit us to locate the material;
- Information reasonably sufficient to permit us to contact You, such as an address, telephone number, and, if available, an electronic mail address at which You may be contacted;
- A statement that You have a good-faith belief that use of the material in the manner complained of is not authorized by the copyright owner, its agent, or the law; and
- A statement that the information in the notification is accurate, and under penalty of perjury, that You are authorized to act on behalf of the owner of an exclusive right that is allegedly infringed.
When we receive a Notice that complies with the Copyright Act, we will remove the identified material promptly.
Links and Pointers to Other Internet Web sites
Friendly Foot Care, PC makes no representations whatsoever about any other web sites that you may access though this Site. When you access a non-Friendly Foot Care, PC web sites, please understand that it is independent from Friendly Foot Care, PC and that Friendly Foot Care, PC has no control over the content on that web sites. In addition, a hyperlink to a non-Friendly Foot Care, PC web sites does not mean that Friendly Foot Care, PC or any entities on the Friendly Foot Care, PC site endorses or accepts any responsibility for the content, or the use, of the linked site. It is up to you to take precautions to ensure that whatever you select for your use or download is free of such items as viruses, worms, Trojan horses and other items of a destructive nature.
Media interviews, videos, recordings, articles and other reports by third party sources regarding Dr. Nirenberg, employees of Friendly Foot Care and/or Friendly Foot Care, PC should not be relied on to provide accurate, complete, or relevant information. In general, media interviews are edited by these third party sources and may not reflect the views, information provided, disclaimers provided, warnings provided or complete or full information provided to the third party at the time of the interview.
Choice of Law and Venue
These Terms and Conditions are entered into in the State of Indiana and shall be governed by and construed in accordance with the laws of the State of Indiana, exclusive of its choice of law rules. Each party to these Terms and Conditions submits to the exclusive jurisdiction of the state and federal courts sitting in the County of Lake in the State of Indiana, and waives any jurisdictional, venue or inconvenient forum objections to such courts. In any action to enforce these Terms and Conditions, the prevailing party will be entitled to costs and attorneys fees. In the event that any of the Terms and Conditions are held by a court or other tribunal of competent jurisdiction to be unenforceable, such provisions shall be limited or eliminated to the minimum extent necessary so that these Terms and Conditions shall otherwise remain in full force and effect.
Availability of Product or Service
Friendly Foot Care, P.C. only does business in the County of Lake in the state of Indiana. Although this website may be accessed from locations where Friendly Foot Care, P.C. does not do business, Friendly Foot Care, P.C. and its employees, physicians, staff, owners, directors, officers do not represent that they do business in those locations or that Friendly Foot Care, P.C.’s services or products will be available in any particular state, country or jurisdiction. This website is not targeted to users in any particular locality. In accessing this site you agree and understand that this site and anything contained on this site will not be used to establish personal jurisdiction over Friendly Foot Care, P.C. or its physicians, staff, employees, agents, owners, directors or officers in locations where it is not currently doing business.
Right to Refuse Service or Terminate Service
Friendly Foot Care, P.C. has the right to refuse service or terminate service for any reason it deems appropriate at its sole discretion.
No individual is considered a patient until one of Friendly Foot Care’s podiatrists performs a preliminary assessment of the individual, provides treatment or recommendations and accepts the individual into the practice.
Right to Change Information and Policies
Friendly Foot Care, PC reserves the right to change any information on this site at any time, with or without notice, and reserves the right to deviate or change policies stated herein without updating these web sites. No one shall be entitled to claim that there is a duty to update information or materials provided on the site (including America’s Podiatrist blog) or to use care to protect the interests of the recipient. Friendly Foot Care, PC reserves the right, in our sole discretion and without obligation, to improve, modify or correct information on the site. Office hours stated herein are intended to only be a general guide. Due to seminars or other events, the office hours may change from time to time, with or without notice, and patients should always contact our office to verify office hours prior to visiting us. There is no guarantee as to which particular doctor will treat you, though an effort will be made to accommodate a patient’s preference when possible.
You agree to idemnify, defend and hold harmless, at your sole expense, Friendly Foot Care, PC and any of their officers, directors, employees, owners, partners and agents from any claim or action brought by a third party relating to (a) your use of the site and/or (b) your breach of the Terms and Conditions of Use.
These Terms and Conditions constitute the entire agreement between Friendly Foot Care, PC and Dr. Nirenberg and you pertaining to the subject matter hereof. In its sole discretion, Friendly Foot Care, PC may modify these Terms and Conditions by posting the revised version on this Site.
No Unlawful or Prohibited Purpose
As a condition of your use of this Site and America’s Podiatrist, you warrant to Friendly Foot Care, PC that you will not use the Site for any purpose that is unlawful or prohibited by these Terms and Conditions.
SUMMARY OF NOTICE OF PRIVACY PRACTICES
The attached Notice of Privacy Practices, which follows this summary, contains a detailed description of how our office will protect your health information, your rights as a patient and our common practices in dealing with patient health information. Please refer to that Notice for further information. We are concerned about your medical and health privacy. This summary is provided to assist you in understanding the attached Notice of Privacy Practices.
The attached Notice of Privacy Practices contains a detailed description of how our office will protect your health information, your rights as a patient and our common practices in dealing with patient health information. Please refer to that Notice for further information.
Uses and Disclosures of Health Information. We will use and disclose your health information in order to treat you or to assist other health care providers in treating you. We will also use and disclose your health information in order to obtain payment for our services or to allow insurance companies to process insurance claims for services rendered to you by us or other health care providers. Finally, we may disclose your health information for certain limited operational activities such as quality assessment, licensing, accreditation and training of students.
Uses and Disclosures Based on Your Authorization. Except as stated in more detail in the Notice of Privacy Practices, we will not use or disclose your health information without your written authorization.
Uses and Disclosures Not Requiring Your Authorization. In the following circumstances, we may disclose your health information without your written authorization:
- To family members or close friends who are involved in your health care;
- For certain limited research purposes;
- For purposes of public health and safety;
- To Government agencies for purposes of their audits, investigations and other oversight activities;
- To government authorities to prevent child abuse or domestic violence;
- To the FDA to report product defects or incidents;
- To law enforcement authorities to protect public safety or to assist in apprehending criminal offenders;
- When required by court orders, search warrants, subpoenas and as otherwise required by the law.
As our patient, you have the following rights:
- To have access to and/or a copy of your health information;
- To receive an accounting of certain disclosures we have made of your health information;
- To request restrictions as to how your health information is used or disclosed;
- To request that we communicate with you in confidence;
- To request that we amend your health information;
- To receive notice of our privacy practices.
If you have a question, concern or complaint regarding our privacy practices, please refer to the attached Notice of Privacy Practices for the person or persons whom you may contact.
FRIENDLY FOOT CARE P.C. 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 REVIEW IT CAREFULLY. THE PRIVACY OF YOUR MEDICAL INFORMATION IS IMPORTANT TO US.
Our Legal Duty
We are required by applicable federal and state laws to maintain the privacy of your protected health information. We are also required to give you this notice about our privacy practices, our legal duties, and your rights concerning your protected health information. We must follow the privacy practices that are described in this notice while it is in effect. This notice takes effect September 23, 2013, and will remain in effect until we replace it.
We reserve the right to change our privacy practices and the terms of this notice at any time, provided that such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our notice effective for all protected health information that we maintain, including medical information we created or received before we made the changes.
You may request a copy of our notice (or any subsequent revised notice) at any time. For more information about our privacy practices, or for additional copies of this notice, please contact us using the information listed at the end of this notice.
Uses and Disclosures of Protected Health Information
We will use and disclose your protected health information about you for treatment, payment, and health care operations.
Following are examples of the types of uses and disclosures of your protected health care information that may occur. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office.
Treatment: We will use and disclose your protected health information to provide, coordinate or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, we would disclose your protected health information, as necessary, to a home health agency that provides care to you. We will also disclose protected health information to other physicians who may be treating you. For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.
In addition, we may disclose your protected health information from time to time to another physician or health care provider (e.g., a specialist or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment to your physician.
Payment: Your protected health information will be used, as needed, to obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend for you, such as: making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for protected health necessity, and undertaking utilization review activities. For example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan to obtain approval for the hospital admission.
Health Care Operations: We may use or disclose, as needed, your protected health information in order to conduct certain business and operational activities. These activities include, but are not limited to, quality assessment activities, employee review activities, training of students, licensing, and conducting or arranging for other business activities. For example, we may use a sign-in sheet at the registration desk where you will be asked to sign your name. We may also call you by name in the waiting room when your doctor is ready to see you. We may use or disclose your protected health information, as necessary, to contact you by telephone or mail to remind you of your appointment.
We will share your protected health information with third party “business associates” that perform various activities (e.g., billing, transcription services) for the practice. Whenever an arrangement between our office and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected health information.
Sale of Health Information: We will not sell or exchange your health information for any type of financial remuneration without your written authorization.
Fundraising Communications: We may use or disclose your health information for fundraising purposes, but you have the right to opt-out from receiving these communications.
Uses and Disclosures Based On Your Written Authorization: Other uses and disclosures of your protected health information will be made only with your authorization, unless otherwise permitted or required by law as described below.
You may give us written authorization to use your protected health information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Without your written authorization, we will not disclose your health care information except as described in this notice.
Others Involved in Your Health Care: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your protected health information that directly relates to that personÃ¢â‚¬â„¢s involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose protected health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death.
Marketing: We may use your protected health information to contact you with information about treatment alternatives that may be of interest to you. We may disclose your protected health information to a business associate to assist us in these activities. If we are paid by a third party to make marketing communications to you about their products or services, we will not make such communications to you without your written authorization. Except as stated above, no other marketing communications will be sent to you without your authorization.
Research; Death; Organ Donation: We may use or disclose your protected health information for research purposes in limited circumstances. We may disclose the protected health information of a deceased person to a coroner, protected health examiner, funeral director or organ procurement organization for certain purposes.
Public Health and Safety: We may disclose your protected health information to the extent necessary to avert a serious and imminent threat to your health or safety, or the health or safety of others. We may disclose your protected health information to a government agency authorized to oversee the health care system or government programs or its contractors, and to public health authorities for public health purposes.
Health Oversight: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.
Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, to track products; to enable product recalls; to make repairs or replacements; or to conduct post marketing surveillance, as required.
Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.
Required by Law: We may use or disclose your protected health information when we are required to do so by law. For example, we must disclose your protected health information to the U.S. Department of Health and Human Services upon request for purposes of determining whether we are in compliance with federal privacy laws. We may disclose your protected health information when authorized by workers compensation or similar laws.
Process and Proceedings: We may disclose your protected health information in response to a court or administrative order, subpoena, discovery request or other lawful process, under certain circumstances. Under limited circumstances, such as a court order, warrant or grand jury subpoena, we may disclose your protected health information to law enforcement officials.
Law Enforcement: We may disclose limited information to a law enforcement official concerning the protected health information of a suspect, fugitive, material witness, crime victim or missing person. We may disclose the protected health information of an inmate or other person in lawful custody to a law enforcement official or correctional institution under certain circumstances. We may disclose protected health information where necessary to assist law enforcement officials to capture an individual who has admitted to participation in a crime or has escaped from lawful custody.
Access: You have the right to look at or get copies of your protected health information, with limited exceptions. You must make a request in writing to the contact person listed herein to obtain access to your protected health information. You may also request access by sending us a letter to the address at the end of this notice. If you request copies, we will charge you: (1) One dollar ($1) per page for the first ten (10) pages; (2) Fifty cents ($.50) per page for pages eleven (11) through fifty (50); and (3) Twenty-five cents ($.25) per page for pages fifty-one (51) and higher; plus (4) our actual cost of postage and mailing if you want the copies mailed to you. If the Practice keeps your health information in electronic form, you may request that we send it to you or another party in electronic form. If you prefer, we will prepare a summary or an explanation of your protected health information for a fee. Contact us using the information listed at the end of this notice for a full explanation of our fee structure.
Accounting of Disclosures: You have the right to receive a list of instances in which we or our business associates disclosed your non-electronic protected health information for purposes other than treatment, payment, health care operations and certain other activities during the past six (6) years. For disclosures of electronic health information, our duty to provide an accounting only covers disclosures after January 1, 2014 and only applies to disclosures for the three (3) years preceding your request. We will provide you with the date on which we made the disclosure, the name of the person or entity to whom we disclosed your protected health information, a description of the protected health information we disclosed, the reason for the disclosure, and certain other information. If you request this list more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests. Contact us using the information listed at the end of this notice for a full explanation of our fee structure.
Restriction Requests: You have the right to request that we place additional restrictions on our use or disclosure of your protected health information. Except as noted herein, we are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency). We are required to accept and follow requests for restrictions of health information to insurance companies if you have paid out-of-pocket and in full for the item or service we provide to you. Any agreement we may make to a request for additional restrictions must be in writing signed by a person authorized to make such an agreement on our behalf. We will not be bound unless our agreement is so memorialized in writing.
Confidential Communication: You have the right to request that we communicate with you in confidence about your protected health information by alternative means or to an alternative location. You must make your request in writing. We must accommodate your request if it is reasonable, specifies the alternative means or location, and continues to permit us to bill and collect payment from you.
Amendment: You have the right to request that we amend your protected health information. Your request must be in writing, and it must explain why the information should be amended. We may deny your request if we did not create the information you want amended or for certain other reasons. If we deny your request, we will provide you a written explanation. You may respond with a statement of disagreement to be appended to the information you wanted amended. If we accept your request to amend the information, we will make reasonable efforts to inform others, including people or entities you name, of the amendment and to include the changes in any future disclosures of that information.
Electronic Notice: If you receive this notice on our website or by electronic mail (e-mail), you are entitled to receive this notice in written form. Please contact us using the information listed at the end of this notice to obtain this notice in written form.
Notice of Unauthorized Disclosures: If the Practice causes or allows your health information to be disclosed to an unauthorized person, the Practice will notify you of this and help you mitigate the effects.
Questions and Other Concerns
If you want more information about our privacy practices or have questions or concerns, please contact us using the information below.
If you believe that we may have violated your privacy rights, or you disagree with a decision we made about access to your protected health information or in response to a request you made, you may notify us by submitting a written complaint to us at:
Name of Contact Person: Michael Nirenberg D.P.M.
Address: 50 West 94th Place, Crown Point IN 46307
We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request. We support your right to protect the privacy of your protected health information.