Notice of Privacy Practices
(trading as Check4Cancer US)
Effective Date: March 1, 2013
THIS NOTICE DESCRIBES HOW PROTECTED HEALTH INFORMATION (“PHI”) ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Your PHI is information about you that is created and received by us, including information that
may reasonably identify you and that relates to your past, present, or future physical or mental
health or condition, or information related to payment for your health care.
We understand the importance of privacy, and are committed to maintaining the confidentiality of
your PHI. We make a record of the medical services we provide, and may receive such records
from others. We use these records to provide or enable other health care providers to provide
quality medical care and to enable us to meet our professional and legal obligations to provide
our services properly. We are required by law to maintain the privacy of PHI and to provide
individuals with notice of our legal duties and privacy practices with respect to PHI. If the privacy
of your unsecured PHI is breached, we are required to notify you following such breach. This
notice describes how we may use and disclose your PHI. It also describes your rights and our
legal obligations with respect to your PHI. If you have any questions about this Notice, please
contact our Privacy Officer, at tel: 877 927 9066.
A. How We May Use or Disclose Your Health Information
The law permits us to use or disclose your health information for the following purposes:
Treatment. We may use PHI about you to provide your medical services. We disclose
PHI to our employees and others who are involved in providing the services you request. For
example, we may share your PHI with your physicians or other health care providers who will
provide services, which we do not provide. We may also share this information with a laboratory
that performs a test.
Payment. We may use and disclose PHI about you to obtain payment for the services
Health Care Operations. We may use and disclose PHI about you for the purposes of
our medical operations. For example, we may use and disclose this information to review and
improve the quality of care we provide, or the competence and qualifications of our professional
staff. We may also use and disclose this information as necessary for medical reviews, legal
services and audits, including fraud and abuse detection and compliance programs and business
planning and management.
Electronic Health Record System. We maintain your PHI in an electronic health record system.
Business Associates. We may share your PHI with our “business associates”, such as
entities or services that perform administrative services for us. We have a written contract with
each of these business associates that contains terms requiring them to protect the confidentiality
of your PHI.
Appointment Reminders, Treatment Alternatives, Benefits and Services. We may use
and disclose PHI to contact and remind you about an appointment. We may also use your health
information in order to recommend possible treatment alternatives or health-related benefits and
services that may be of interest to you.
Notification and Communication with Family. With your permission we may disclose your
health information to a family member or a close friend or other person you identify where
relevant to that person’s involvement in your care or payment for your care. We may disclose
your health information to notify or assist in notifying a family member, your personal
representative or another person responsible for your care about your location and your general
condition. If you are able and available to agree or object, we will give you the opportunity to
object prior to making these disclosures, although we may disclose this information in a disaster
even over your objection if we believe it is necessary to respond to the emergency
circumstances. If you are unable or unavailable to agree or object, our health professionals will
use their best judgment in communicating with your family and others.
Required by Law. As required by law, we will use and disclose your health information,
but we will limit our use or disclosure to the relevant requirements of the law. We may, and are
sometimes required by law to disclose your health information to public health authorities for
purposes related to: preventing or controlling disease, injury or disability; reporting abuse or
neglect; reporting domestic violence; reporting to the Food and Drug Administration problems
with products and reactions to medications; and reporting disease or infection exposure.
Health Oversight Activities. We may, and are sometimes required by law to disclose your
health information to health oversight agencies during the course of audits, investigations,
inspections, licensure and other proceedings.
Judicial and Administrative Proceedings. We may, and are sometimes required by law,
to disclose your health information in the course of any administrative or judicial proceeding to the
extent expressly authorized by a court or administrative order. We may also disclose information
about you in response to a subpoena, discovery request or other lawful process if the law permits
Workers’ Compensation. We may disclose your health information as necessary to
comply with workers compensation laws. For example, to the extent your care is covered by
workers’ compensation, we will make periodic reports to your employer about your condition. We
are also required by law to report cases of occupational injury or occupational illness to the
employer or workers’ compensation insurer.
Completely De-identified Information. We may use and disclose your health information
if we have removed any information that has the potential to identify you so that the health
information is "completely de-identified."
B. When We May Not Use or Disclose Your Health Information
Except as described in this Notice of Privacy Practices, and as permitted by applicable state or
Federal law, we will not use or disclose your PHI without your written authorization. You may
also initiate the transfer of your records to another person by completing a written authorization
form. If you provide us with written authorization, you may revoke that written authorization at any
time, except to the extent that we have already relied upon it. You understand that we are unable
to take back any disclosures we have already made with your permission, and that we are
required to retain our records of the care that we provide to you.
We need your specific authorization before we use or disclose your PHI for the activities
Marketing. A signed authorization is required for the use or disclosure of your PHI for a
purpose that encourages you to purchase or use a product or service except for certain
limited circumstances such as when the marketing communication is face-to-face or
when marketing includes the distribution of a promotional gift of nominal value provided
Sale of PHI. A signed authorization is required for the use or disclosure of your PHI in
the event that we receives remuneration for such use or disclosure, except under certain
circumstances as allowed by federal or applicable state law.
C. Your Health Information Rights
Right to Request Special Privacy Protections. You have the right to request restrictions
on certain uses and disclosures of your health information, by submitting a written request
specifying what information you want to limit and what limitations on our use or disclosure of that
information you wish to have imposed. We are not required to agree to your request for a
restriction, unless it involves the disclosure of PHI to a health plan for purposes of carrying out
payment or health care operations that pertains solely to a health care item or service for which
we has been paid out of pocket in full. We will notify you of our decision.
Right to Request Confidential Communications. You have the right to request that you
receive your health information in a specific way or at a specific location. For example, you may
ask that we send information to a particular e-mail account or to your work or home address. We
will comply with all reasonable requests submitted in writing which specify how or where you wish
to receive these communications.
Right to Inspect and Copy. You have the right to inspect and copy your health
information, with limited exceptions. This includes the right to obtain an electronic copy of your
health information maintained in our electronic health record. To access your PHI, you must
submit a written request detailing what information you want access to and whether you want to
inspect it or get a copy of it. If you request a paper copy of the information, we may charge a fee
for the costs of copying, mailing or other supplies we use to fulfill your request. If you request an
electronic copy, we may charge a fee for our labor costs in fulfilling your request. We may deny
your request under limited circumstances.
Right to Amend. You have a right to request that we amend your health information that
you believe is incorrect or incomplete. You must make a request to amend in writing, and include
the reasons you believe the information is inaccurate or incomplete. We are not required to
change your health information, and will provide you with information about our denial and how
you can disagree with the denial. We may deny your request under certain circumstances.
Right to an Accounting of Disclosures. You have a right to receive an accounting of
disclosures of your health information made by us or by others on our behalf. An accounting of
disclosures does not include information about disclosures made: to you or your personal
representative; pursuant to your written authorization; for treatment, payment or business
operations (unless such disclosures were made from our electronic health record, as noted
below); or to family and friends involved in your care or payment for your care. To request an
accounting of disclosures, you must submit a request in writing, stating a time period beginning
that is within six (6) years of the date of your request. The first accounting provided within a
twelve-month period will be free. We may charge you a reasonable, cost-based fee for each
future request for an accounting within a single twelve-month period. An accounting of
disclosures made from the electronic health record system related to treatment, payment or
health care operations will be made only for the three (3) year period preceding the request,
beginning on the date that we are required to provide an accounting of such disclosures under
Right to Receive a Notice of Privacy Practices. You have a right to receive a paper copy
of this Notice of Privacy Practices. If you would like to have a more detailed explanation of these
rights or if you would like to exercise one or more of these rights, contact our Privacy Officer listed
at the top of this Notice of Privacy Practices.
D. Special Rules Regarding Disclosure of Certain Health Information
Additional restrictions may apply to disclosures of health information that relates to care for
psychiatric conditions, substance abuse or HIV-related testing and treatment. In most cases, this
information may not be disclosed without your specific written permission, except as may be
specifically required or permitted by federal or applicable state law.
Mental Health Information. Certain mental health information may be disclosed for treatment,
payment, and health care operations as permitted or required by law. Otherwise, we will only
disclose such information pursuant to an authorization or court order, or as otherwise required by
Substance Abuse Treatment Information. If we have information regarding treatment you have
received in a substance abuse program, Federal law protects the confidentiality of patient records
containing information about alcohol and drug abuse. These records may be disclosed only upon
HIV-Related Information. We may disclose HIV-related information only as permitted or
required by state law. For example, state law may allow HIV-related information to be disclosed
without your authorization for treatment purposes, certain health oversight activities, when
pursuant to a court order, or in the event of certain exposures to HIV by our personnel, another
person, or a known partner.
E. Changes to this Notice of Privacy Practices
We reserve the right to amend this Notice of Privacy Practices at any time in the future. Until
such amendment is made, we are required by law to comply with this Notice. After an
amendment is made, the revised Notice of Privacy Protections will be posted on our website and
will apply to all PHI that we maintain, regardless of when it was created or received.
Complaints about this Notice of Privacy Practices or how we handle your health information
should be directed to our Privacy Officer listed at the top of this Notice of Privacy Practices.
You may also submit a complaint to:
Department of Health and Human Services
Office of Civil Rights
Hubert H. Humphrey Bldg.
200 Independence Avenue, S.W.
Room 509F HHH Building
Washington, DC 20201
You will not be penalized for filing a complaint.
Please check this box to indicate you have read and agree to the terms.
If you want to schedule your own appointment check this box. If not then we will call you within 3-5 days to schedule you appointment.
Please be aware that the registration window is limited to 2 hours. There after you will have lost you chosen
appointment slot and will need to start the booking process again. Your personal details will however be saved.
Self booking system
You can now book your appointment using our self booking system below.
We may add additional clinic times and locations, so if you cannot find an appointment time or location
to suit you below, please continue registering by clicking here and we will contact you when more appointment times have been added.
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Please select a location first.
Please select a date/time first.
Thank you for booking through our online system.
If you have any queries or would like to cancel or alter your appointment, please contact us directly.
If you would prefer one of our practice managers to contact you about your appointment, click here.