Privacy Practice Notice

We understand medical information about your health is personal. Based on HIPPA we are committed to protect your medical information. At Amara Pain & Spine we create a record of the care you receive, to provide you the best quality care and follow the legal requirements. This notice will inform you about the ways in which we may use and disclose medical information about you, your rights and certain obligations we have regarding the use and disclosure of medical information.

How we may use and disclose your medical Information: The following describes the ways we may use and disclose health information that identifies you. Except for the purposes described below, we will use and disclose Health Information only with your written permission.?

For Treatment:

We can use your health information and share it with other professionals who are treating you.

For Payment:

We can use and share your health information to bill and get payment from health plans or other entities.

For Health Care Operations:

We can use and share your health information to improve your care, run our practice, and contact you when necessary.

Individuals Involved in Your Care or Payment for Your Care:

When appropriate, we can share Health Information with a person, who is involved in your medical care.

Appointment Reminders and HHealth-RelatedBenefits and Services:

We can share and disclose Health Information to contact you for appointment reminder or to let you know about treatment alternatives or health-related benefits and services that may be useful and of interest to you.

For Law:

We can share and disclose Health Information to federal, state or local laws when required by them.

For Health or Safety:

We can share and disclose Health Information about you when necessary to prevent a serious threat to your health or of the public or another person.

Public Health Risks:

We can share Health Information about you for certain situations:

  • to report births and deaths;
  • to prevent or control disease;
  • to report child abuse or neglect;
  • to report reactions to medications
  • to notify people of recalls of products they may be using
  • notify a person who may have been exposed to a disease or may be at risk.

Lawsuits and Legal Disputes:

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Comply with the Law:

We will share information about you if state or federal laws requires it, including with Health and Human Services when required.

Coroners, Medical Examiners and Funeral Directors:

We can share Health Information to a coroner, medical examiner or funeral director when an individual dies.


Under certain circumstances, we can share and disclose Health Information for research. Before we use or disclose Health Information for research, the project will go through a special approval process.

Organ and Tissue Donation:

We can share health information about you with organ procurement organizations.

Workers’ Compensation, Law Enforcement and Other Government Agencies:

We  may share health information about you for workers’ compensation, for law enforcement purpose or special government organizations  such as military or  national security.

For All Other Uses and Disclosures:

All other uses and disclosures of information not contained in this Notice of Privacy Practices will not be disclosed without your authorization.

When Your Written Authorization Is Required:

In these cases, we never share your information unless you have given us written permission for marketing Purposes/ sale of your information or sharing of psychotherapy notes. If you give us an authorization, you can revoke it at any time by submitting a written revocation to our office and we will no longer disclose Protected Health Information under the authorization, however this will be only effective after written notice is received not prior to it.

Your Rights:

You have the following rights regarding your Health Information

Right to Inspect and Obtain a Copy of Your Medical Records:

You can ask to see or get an electronic copy of your medical record or other health information we have about you. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Right to Correct Your Medical Records:

You can ask us to correct health information about you that you think is incorrect or incomplete. We may also say “no” to your request, but we will tell you why within 60 days.  You can send an amendment request to our office in writing.

Right to Limit Information:

You have the right to ask us not to use or share certain Health Information for treatment, payment, or health care operations unless required by law.

Right to Request Confidential Communications:

You have the right to request that we communicate with you about medical matters in a certain way by sending written request.

Right to an Account of Disclosures:

You can ask us for a list of the times we have shared your health information for three years prior to the date you ask, who we shared it with and why. We will include all the disclosures except those about treatment, payment and health care operations, and certain other disclosures. There will be a reasonable, cost-based fee


If you believe your privacy rights have been violated, you may file a complaint with our office by contacting our office in writing.

Changes to this Notice:

We reserve the right to change this notice and make a new notice that applies to the Health Information. We will update our website

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