Privacy Policy

I understand that as part of the delivery of my health care, PFC PLLC originates and maintains medical records describing my health history, symptoms, examination and test results, diagnoses, treatment and plans for future care or treatment. I understand that this information serves as: • A basis for planning my care and treatment • A means of communication among the health care professionals who contribute to my care • A tool for routine health care operations such as assessing quality and ensuring the continued competence of health care professionals involved in my care • I have been provided with a Notice of Information Practices that provides a more complete description of the uses and disclosures of my health information. • I understand that PFC PLLC reserves the right to change this notice and their practices as needed and will make a reasonable attempt to inform me. I understand that I have the right to request restrictions(s) in the use or disclosure of my health information for treatment or healthcare operations and that PFC PLLC are not required to agree to the restrictions requested. • I understand that I may revoke this acknowledgement in writing except to the extent that PFC PLLC has already taken action based on it. If I would like to request a restriction in the use or disclosure of my health information I will provide it in writing.