Common use of Right to Provide an Authorization for Other Uses and Disclosures Clause in Contracts

Right to Provide an Authorization for Other Uses and Disclosures. Our Practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. You have the right, at any time, to revoke your authorization to disclose your PHI. Simply send a written notice of revocation to the Privacy Officer at the address provided above. After you revoke your authorization, we will no longer use or disclose your PHI for the reasons described in the authorization. Please note, we are required to retain records of your care. Again, if you have questions regarding this notice or our health information privacy policies, please contact the Privacy Officer listed above.

Appears in 4 contracts

Samples: Patient Agreement, Health Patient Agreement, Health Patient Agreement

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