Thank you for choosing Veritas Clinical Specialties, LTD
We value you as research participant
~~NOTICE OF PRIVACY~~
Veritas Clincal Specialties, LTD
Effective 01/11/2006
NOTICE OF PRIVACY PRACTICE
As Required by the Privacy Regulations
Created as a Result of the Health Insurance Portablity and
Accountability Act of 1996
(HIPAA)
This notice describes how health information about you
(as a research participant with Veritas Clinical Specialties,
LTD) may be used and disclosed, and how
you can get access to your individually identifiable health information.
This notice
describes the privacy protections that are especially relevant to research
participants. You have additional protections and rights that are applicable
to all health
care consumers. For a complete listing of those rights please contact Veritas
Clinical Specialties, LTD.
Please review this notice carefully.
Our Commitment To Your Privacy:
Veritas Clinical Specialties, LTD. is dedicated to maintaining
the privacy of your individually identifiable health information
(IIHI). In conducting
our business,
we will create records regarding you and the treatment and services we
provide to 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 the privacy practices that we maintain in our
practice concerning your IIHI. By Federal and State law, we
must follow the terms
of the notice of privacy practices that we have in effect at the time.
The
terms of this notice apply to all records containing your IIHI
that are created or retained by our practice. We reserve the
right to revise
or amend
this Notice
of Privacy Practices. Any revision or amendment to this notice will be
effective for all of your records that our practice has created or maintained
in the
past, and for any of your records that we may create or maintain in the
future. Our
practice will post a copy of our current Notice in our offices in a visible
location at all times, and you may request a copy of our most current
Notice at any time.
IHI FOR RESEARCH PURPOSES:
Veritas Clinical Specialties,
LTD may use and disclose your IIHI for research purposes in certain
limited circumstances.
We will obtain
your written authorization to use your IIHI for research purposes except
when an Institutional Review Board or Privacy Board has determined
that the waiver
of your authorization satisfied the following: (i) the use or disclosure
involves no more than a minimal risk to your privacy based on the following:
(A) an
adequate plan to protect the identifiers from improper use and disclosure;
(B) an adequate
plan to destroy the identifiers at the earliest opportunity consistent
with the research (unless there is a health or research justification
for
retaining
the
identifiers or such retention is otherwise required by law; and (C)
adequate written assurances that the PHI will not be re-used or
disclosed to any
other person or entity (except as required by law) for authorized oversight
of
the research study, or for other research for which the use or disclosure
would
otherwise be permitted; (ii) the research could not practicably be
conducted without the
waiver; and (iii) the research could not practicably be conducted without
access to and use of the PHI.
Confidential Communications.
You have
the right to request that our practice communicate with you about
your health and related issues
in a particular
manner or at a certain location. For example, you may ask that we
contact you at home
rather than at work. In order to request a type of confidential communication,
you must make written request specifying the requested method of
contact, or the location where you wish to be contacted. Our practice
will accommodate
reasonable requests. You do not need to give a reason for your request.
Right To A Paper Copy Of This Notice.
You are entitled to receive
a paper copy of a complete notice of privacy practices. You may
ask us
to give
you a copy
of such notice at any time. Right To
File A Complaint.
If you believe
your privacy rights have been violated, you may file a complaint
with our practice or with the
Secretary
of the Department
of Health & Human Services. All complaints must be submitted
in writing, and you will not be penalized for filing a complaint.
Please direct any questions or concerns regarding this notice
or our health information privacy policies to:
Luanne Leeds
Director Human Subjects Protection
515 SW Horne Street
Topeka Kansas, 66610
Phone: (785) 354-0735
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