Correctional institution. If you are an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your ealth and the health and safety of other individuals. • Law enforcement. We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. • Health oversight agencies and public health authorities. If members of our work force or business associates believe in good faith that we have engaged in unlawful conduct or otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public, they may disclose your health information to health oversight agencies and/or public health authorities, such as the Department of health. • The federal Department of Health and Human Services (“DHHS”). Under the privacy standards, we must disclose your health information to DHHS as necessary to determine our compliance with those standards. I have read, understood and agreed to Neurohealth’s Privacy Policy. SIGNATURE DATE PRINTED NAME Emerging Technology Treatment Procedures: What is involved with the Neurofeedback Treatment Program? The Importance of Regular Attendance and Participation: Physician Consultation and Medication Monitoring:
Correctional institution. Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals.
Correctional institution. If you are or become an inmate of a correctional institution, we may disclose PHI to the institution or its agents when necessary for your health or the health and safety of others.
Correctional institution. Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals. Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.
Correctional institution. If you are or become an inmate of a correctional institution, we may disclose PHI to the institution or its agents when necessary for your health or the health and safety of others. To avert a serious threat to health or safety: We may use and disclose PHI about you when we believe in good faith that disclosure is necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person and the disclosure is to a person reasonably able to prevent the threat. We may disclose your PHI for a medical emergency when we are unable to obtain your consent or authorization due to your condition or the nature of the medical emergency Victims of abuse, neglect, or domestic violence: We may disclose PHI about you to a government authority, such as a social service or protective services agency, if we reasonably believe, in our professional judgment, you are a victim of abuse, neglect, or domestic violence. We will only disclose this type of information (1) to the extent required by law, (2) if you agree to the disclosure, or (3) if the disclosure is allowed by law and we believe it is necessary to prevent serious harm to you or someone else or the law enforcement or public official that is to receive the report represents that it is necessary and will not be used against you.
Correctional institution. If you are an inmate of a correctional institution, we may disclose to the institution or agents thereof, health in- formation necessary to provide you with healthcare; to protect your health and safety or the health and safety of other individuals; or for the safety and security of the correctional institution.
