Summary HIPAA Notice of Privacy Practices

TheShifa Free Clinic complies with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  The Shifa Free Clinic protects confidential health care information, known as “Protected Health Information” (PHI).

Below is a summary of your privacy rights under HIPAA.

Please see the attached details.

The Shifa Free Clinic legal duties and privacy practices regarding your PHI are also included in this Summary Notice.

Summary of Your Privacy Rights
Shifa Free Clinic may use and give your health information to:
• Treat you
• Operate health care services

The Shifa Free Clinic may use and give your health information for:
• Law enforcement requests
• Judicial and administrative proceedings related to legal actions
• Healthcare fraud and abuse detection or compliance with the law
• Use by another healthcare provider treating you
• Government health oversight activities
Reports required by law related to births, deaths or diseases
• Reports required by law related to neglect and abuse, or domestic violence
• Notifying a party about exposure to a possible communicable disease
• Military, national defense and security or other governmental functions
• Workers’ compensation purposes and in compliance with related laws
• Averting a serious threat to public health and safety

You have the right to:
• Inspect or get a copy of your medical record
• Change information on your medical record if you think it is incorrect
• Get a list of persons whom The Shifa Free Clinic shared your PHI
• Ask The Shifa Free Clinic to limit the information it shares
• Ask for a copy of your privacy notice
• Write a letter of complaint to The Shifa Free Clinic or the federal government

If you have any questions or if you wish to file a complaint, or exercise any rights listed in this Summary or the complete Notice, please contact  The Shifa Free Clinic at Shifa.SC@icnarelief.org