Common use of Right to Request Restrictions Clause in Contracts

Right to Request Restrictions. You have the right to request that we follow additional, special restrictions when disclosing your information. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment as determined by a doctor. To request restrictions, you must make your request in writing to your service provider. In your request, you must tell us what information you want to limit, the type of limitation, and to whom you want the limitation to apply.

Right to Request Restrictions. You have the right to request that a restriction or limitation on the medical information we follow additionaluse or disclose about you for treatment, special restrictions when disclosing your informationpayment or health care operations. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment as determined by a doctortreatment. To request restrictions, you must make your request in writing to your service providerMedical Records marked "personal and confidential". In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, the type of limitation, disclosure or both; and (3) to whom you want the limitation limits to apply.

Right to Request Restrictions. You have the right to request that a restriction or limitation on the information we follow additionaluse or disclose about you for treatment, special restrictions when disclosing payment, and health care operations or to someone who is involved in your informationcare or the payment for your care. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment as determined by a doctorin an emergency. To request restrictions, you You must make your request in writing to your service providerthe Office Manager. In your request, you You must tell us (1) what information you want to limit; (2) whether you want to limit our use, the type of limitation, disclosure or both; and (3) to whom you want the limitation limits to apply.