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 Health Insurance Portability and Accountability Act of 1996, known as HIPAA, is a federal law that requires medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, to be kept properly confidential. HIPAA gives patients important rights to understand and control how their health information is used.

This Notice of Privacy Practices describes how Associated Family Physicians may use and disclose your Protected Health Information, also known as PHI, to carry out treatment, payment, healthcare operations, and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information.

“Protected health information” includes information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health condition, treatment, or related healthcare services.

Uses and Disclosures of Protected Health Information

Your Protected Health Information may be used and disclosed by your physician, our clinic staff, and others involved in your care and treatment for the purpose of providing healthcare services to you, obtaining payment for healthcare services, supporting the operations of our practice, and any other use required or permitted by law.

Treatment: We may use and disclose your Protected Health Information to provide, coordinate, or manage your healthcare and any related services. This may include the coordination or management of your healthcare with another provider or a third party involved in your care. For example, your protected health information may be provided to a physician, specialist, or healthcare professional to whom you have been referred so they have the information needed to diagnose, treat, or support your care.

Payment: Your Protected Health Information may be used, as needed, to obtain payment for healthcare services. For example, information may be shared with your health plan or insurance provider to verify coverage, obtain authorization, process claims, or receive payment for services provided.

Healthcare Operations: We may use or disclose your Protected Health Information, as needed, to support the business activities of our medical practice. These activities may include quality assessment, staff training, employee review activities, licensing, compliance, business administration, appointment scheduling, and other operational functions necessary to provide care. We may use a sign-in sheet at the registration desk where you may be asked to sign your name. We may also call you by name in the waiting room when your provider is ready to see you. We may use or disclose your Protected Health Information, as necessary, to contact you to remind you of an appointment, the need to schedule a new appointment, or to follow up regarding your care. We may call your home or preferred phone number and leave a message, either on an answering machine, voicemail, or with the person answering the phone. We may also contact you by mail, text, email, or other communication methods when permitted. If you prefer that we contact you at another telephone number, address, or location, please let us know.

 

Uses and Disclosures Permitted or Required by Law

We may use or disclose your Protected Health Information without your written authorization in certain situations permitted or required by law. These may include, but are not limited to:

• Uses or disclosures required by law

• Public health activities

• Communicable disease reporting

• Health oversight activities

• Abuse, neglect, or domestic violence reporting

• Food and Drug Administration requirements

• Legal proceedings

• Law enforcement purposes

• Coroners, medical examiners, funeral directors, and organ donation organizations

• Research, when legally permitted

• Serious threats to health or safety

• Military activity and national security

• Workers’ compensation

• Inmates or individuals in custody

• Other uses and disclosures required by the Secretary of the U.S. Department of Health and Human Services to investigate or determine our compliance with HIPAA

Other permitted and required uses and disclosures will be made only with your consent, authorization, or opportunity to object, unless otherwise required by law.

 

You may revoke an authorization at any time in writing, except to the extent that Associated Family Physicians has already taken action in reliance on that authorization.

Your Rights
The following is a statement of your rights with respect to your Protected Health Information.

You have the right to inspect and request copies of your Protected Health Information. Under federal law, however, certain records may not be available for inspection or copying, including psychotherapy notes, information compiled in reasonable anticipation of or use in a civil, criminal, or administrative action or proceeding, and information that is subject to laws prohibiting access.

Right to Request Restrictions
You have the right to request a restriction on how we use or disclose your Protected Health Information for treatment, payment, or healthcare operations. You may also request that certain information not be disclosed to family members, friends, or others involved in your care or payment for your care.

Your request must state the specific restriction requested and to whom the restriction should apply. We are not required to agree to all requested restrictions. If we do agree, we will comply with the restriction unless the information is needed to provide emergency treatment or disclosure is otherwise required by law.

Right to Request Confidential Communications
You have the right to request that we communicate with you by alternative means or at an alternative location. For example, you may request that we contact you at a specific phone number, mailing address, or email address. We will accommodate reasonable requests when possible.

Right to Receive a Paper Copy
You have the right to obtain a paper copy of this Notice upon request, even if you have agreed to receive this Notice electronically.

Right to Request an Amendment
You may have the right to request that we amend your Protected Health Information if you believe it is incorrect or incomplete. If we deny your request, you have the right to submit a written statement of disagreement. We may prepare a rebuttal to your statement, and we will provide you with a copy of any rebuttal.

Right to an Accounting of Disclosures
You have the right to receive an accounting of certain disclosures we have made of your Protected Health Information, when required by law. This accounting will not include disclosures made for treatment, payment, or healthcare operations, disclosures you authorized, or certain other disclosures permitted by law.

Complaints
You may complain to us or to the Secretary of the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. You may file a complaint with us by notifying our Privacy Officer at the contact information listed below.

We will not retaliate against you for filing a complaint.

Changes to This Notice
Associated Family Physicians reserves the right to change the terms of this Notice and to make the revised Notice effective for all Protected Health Information that we maintain. Any updated Notice will be made available upon request and may be posted on our website.

Acknowledgment
By receiving care from Associated Family Physicians or using our services, you acknowledge that this Notice of Privacy Practices has been made available to you and that you understand how your Protected Health Information may be used and disclosed as described above.

This Notice was published and becomes effective on/or before 6/20/2026 .

The name and address of the person or office you can contact for further information concerning our privacy practices is:

Privacy Officer

Associated Family Physicians
9910 Sandalfoot Blvd
Boca Raton, FL 33428

Phone: (561) 883-3030