SCA
Surgical Care Affiliates

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

At Surgical Care Affiliates (“SCA”), we understand that medical information about you and your health is personal, and we are committed to protecting that information. This Notice of Privacy Practices describes how we and the medical staff and personnel who provide you with care or services at this facility may use and disclose your Protected Health Information (“PHI”) to carry out treatment, payment or healthcare operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your PHI, which is information about you, including demographic information that may identify you and that relates to your past, present or future physical or mental health or condition and related healthcare services. We are required by law to maintain the privacy of your PHI, to provide notice of our legal duties and privacy practices with respect to your PHI, to notify affected individuals following a breach of unsecured PHI, and to abide by the terms of this Notice of Privacy Practices.

We may change the terms of our notice at any time. The new notice will be effective for all PHI that we maintain at that time. Upon your request, you can receive any revised Notice of Privacy Practices by accessing our website www.scasurgery.com, contacting the facility where you received services, or by contacting the Privacy Officer : privacy.officer@scasurgery.com.

1. How We May Use and Disclose Your PHI.
We may use or disclose your PHI as described in this section. The following are examples of the types of uses and disclosures of your PHI that SCA is permitted to make without your specific authorization. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our facility. Where State or federal law restricts one of the described uses or disclosures, SCA will follow the requirements of such State or federal law. The following are general descriptions only. They do not cover every example of disclosure within a category. However, all of the ways SCA is permitted to use and disclose your PHI will fall within one of the categories in this Notice of Privacy Practices.

Treatment. We may use PHI about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students or other personnel who are involved in your care to, for example, plan a course of treatment for you. We also may disclose PHI about you to individuals outside of SCA who may be involved in your medical care, such as family members or others we use to provide services that are part of your care.

Payment. Your PHI will be used, as needed, to obtain payment for your healthcare services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the healthcare services we recommend for you, such as making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity and undertaking utilization review activities. For example, obtaining approval for a surgery may require that your relevant PHI be disclosed to your health plan.

Healthcare Operations. We may use or disclose your PHI as needed to support our business activities. These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, licensing, and conducting or arranging for other healthcare operations. For example, your health information may be disclosed to members of the medical staff, risk or quality improvement personnel and others to:

• Evaluate the performance of our staff;
• Assess the quality of care and outcomes in your case and similar cases;
• Learn how to improve our facilities and services; or
• Determine how to continually improve the quality and effectiveness of the health care we provide.

In addition, we may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician. We may also call you by name in the waiting room when your healthcare provider is ready to see you. We may use or disclose your PHI, as necessary, to contact you to remind you of your appointment.

We will share your PHI with third party “business associates” that may perform various activities (e.g., billing or transcription services) for SCA. Whenever an arrangement between our facility and a business associate involves the use or disclosure of your PHI, we will require the business associate to appropriately safeguard it.

2. Other Permitted and Required Uses and Disclosures That May Be Made With Your Authorization or Opportunity to Object. You have the opportunity to authorize or object to the use or disclosure of all or part of your PHI. You may revoke your authorization at any time, but your revocation will only be effective for future uses and disclosures and will not affect any use or disclosure made in reliance on your authorization. If you are not present or able to authorize or object to the use or disclosure of the PHI, then your healthcare provider may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only the PHI that is relevant to your healthcare will be disclosed. We may use and disclose your PHI in the following instances. Other uses and disclosures not described in this Notice of Privacy Practices will be made only with your written authorization.

Facility Directories. Unless you object, we will use and disclose in our facility directory your name, the location at which you are receiving care, your condition (in general terms) and your religious affiliation. All of this information, except religious affiliation, will be disclosed to people that ask for you by name. Members of the clergy will be told of your religious affiliation.

Others Involved in Your Healthcare. Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your PHI that directly relates to that person’s involvement in your healthcare. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose PHI to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, about your general condition or death. Finally, we may use or disclose your PHI to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your healthcare.

In addition, with few exceptions, unless you provide written authorization, we will not use or disclose your PHI for marketing purposes and we will not sell your PHI.

3. Other Permitted and Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Object. We may use or disclose your PHI without your authorization in the following situations:

Required By Law. We may use or disclose your PHI to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures.

Public Health. We may disclose your PHI for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability. We may also disclose your PHI, if directed by the public health authority, to a foreign government agency that is collaborating with the public health authority.

Communicable Diseases. We may disclose your PHI, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

Health Oversight. We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations and inspections. Oversight agencies seeking this information include government agencies that oversee the healthcare system, government benefit programs, other government regulatory programs and civil rights laws.

Abuse or Neglect. We may disclose your PHI to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your PHI to the governmental entity or agency authorized to receive such information if we believe that you have been a victim of abuse, neglect or domestic violence. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.

Food and Drug Administration (“FDA”). We may disclose your PHI to a person or company required by the FDA to report information such as adverse events and product defects, to enable product recalls, to make repairs or replacements, or to conduct post marketing surveillance.

Legal Proceedings. We may disclose PHI in response to a court or administrative order. We may also disclose PHI in response to a subpoena, discovery request, or other lawful process, but only if a reasonable effort has been made to tell you about the request or to obtain an order protecting the information requested.

Law Enforcement. We may release PHI for certain law enforcement purposes including, for example, reports required by law, to comply with a court order or warrant, or to report or answer questions about a crime.

Coroners, Funeral Directors and Organ Donation. We may disclose PHI to a coroner, funeral director or medical examiner as necessary to permit them to carry out their duties.

Research. We may disclose your PHI to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your PHI.

Criminal Activity. Consistent with applicable federal and state laws, we may disclose your PHI if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose PHI if it is necessary for law enforcement authorities to identify or apprehend an individual.

Military Activity and National Security. When the appropriate conditions apply, we may use or disclose PHI of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits or (3) to foreign military authority if you are a member of that foreign military services. We may also disclose your PHI to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President of the United States or other officials.

Workers’ Compensation. Your PHI may be disclosed by us as authorized to comply with workers compensation laws and other similar legally established programs.

Required Uses and Disclosures. Under the law, we must make disclosures to you and to the U.S. Department of Health and Human Services when required to determine our compliance with the requirements of the Federal Privacy Standards.

4. Your Rights. Following is a statement of your rights with respect to your PHI and a brief description of how you may exercise these rights. We have the right to deny your request in certain circumstances. We will inform you if your request is denied.

Right to Access Your PHI. You may inspect and obtain a copy of PHI about you that is contained in a designated record set for as long as we maintain the PHI. A “designated record set” contains medical and billing records and any other records that your healthcare provider and SCA use for making decisions about you. Under federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal or administrative action or proceeding; and, PHI that is subject to law that prohibits access to PHI. Depending on the circumstances, a decision to deny access may be reviewable. If the information you request is maintained electronically, and you request an electronic copy, we will provide a copy In the electronic form and format you request, if the information can be readily produced in that form and format. If the information cannot be readily produced in that form and format, we will work with you to come to an agreement on form and format.

Please contact the facility’s Medical Records Department if you have questions about access to your PHI. If you request a copy of the information, we may charge a fee for the costs of retrieving, copying, mailing and any other supplies associated with your request. Your records remain the property of SCA.

Right to Request a Restriction on the Use or Disclosure of Your PHI. You may ask us not to use or disclose any part of your PHI for the purposes of treatment, payment or healthcare operations. You may also request that any part of your PHI not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in the Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply. Except as provided in the following paragraph, we are not required to agree to your request. However, if we do agree to the request, we will honor the restriction until you revoke it or we notify you.

We will comply with any restriction request if (1) except as otherwise required by law, the disclosure is to a health plan for purposes of carrying out payment or health care operations (and is not for purposes of carrying out treatment); and (2) the PHI pertains solely to a health care item or service for which the health care provider involved has been paid out-of-pocket in full. SCA is not responsible for notifying subsequent health care providers of your request for restrictions on disclosures to health plans for those items and services, so you will need to notify other providers if you want them to abide by the same restriction.

To request restrictions, you must make your request in writing to SCA. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply (for example, disclosures to your spouse).

Right to Request to Receive Confidential Communications From Us . You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. We will attempt to accommodate reasonable requests. We will not request an explanation from you as to the basis for the request. Please make this request in writing to the facility’s Medical Records Department.

Right to Request Amendment. If you think that the PHI we have about you is wrong or incomplete, you may ask us to amend the information. In certain cases, we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Please contact the facility’s Medical Records Department if you have a question about amending your medical record.

Right to Request an Accounting of Certain Disclosures. You may request a list of our disclosures of your PHI, subject to several exceptions and limitations. For example, this right does not apply to disclosures for purposes other than treatment, payment or healthcare operations, and it excludes disclosures we may have made to you, to family members or friends involved in your care, or for notification purposes. You have the right to receive specific information regarding these disclosures. To request this list or accounting of disclosures, you must submit your request in writing to SCA’s Privacy Officer. Your request must state a time period that may not be longer than six years prior to the request date and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free. For additional lists during the same 12-month period, we may charge you for the cost of providing the list. We will notify you of the cost Involved and you may choose to withdraw or modify your request at the time before any costs are incurred.

Right to Be Notified of a Breach. You have a right to be notified in the event that we discover a breach of unsecured PHI, as defined under federal law.

Right to Obtain a Paper Copy of This Notice. You have the right to obtain a paper copy of this notice, even if you agreed to receive such notice electronically. You may ask us to give you a copy of this notice at any time. To request a copy of this notice, you can make your request in writing to SCA’s Privacy Officer (contact information is below).

5. Questions and Complaints.
You may file a complaint with us or with the Secretary of the Department of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Privacy Officer of your complaint. We will not retaliate against you for filing a complaint. For further information about the complaint process, or to make any requests or inquiries, you may contact our Privacy Officer at:

Privacy Officer
Surgical Care Affiliates
510 Lake Cook Road, Suite 400
Deerfield, IL 60015
Telephone: (205) 545-2713
E-mail: privacy.officer@scasurgery.com

This notice was effective on April 14, 2003 and revised on May 2, 2017.

隱私慣例通知
本通知描述了您可以使用和披露的醫療信息，以及如何訪問本信息。請仔細閱讀。

在外科護理關聯公司（“SCA”），我們了解到有關您和您的健康的醫療信息是個人的，我們致力於保護該信息。本隱私慣例通知介紹了我們以及在此設施向您提供護理或服務的醫護人員和人員如何使用和披露您的受保護的健康信息（“PHI”）進行治療，支付或醫療保健操作以及其他目的這是法律允許或要求的。它還描述了您訪問和控制您的PHI的權限，這是您的信息，包括可能識別您的人口統計信息，以及與過去，現在或未來的身體或精神健康或狀況及相關保健服務相關的人口統計信息。法律要求我們保持您的PHI的隱私，提供關於您的PHI的法律責任和隱私慣例的通知，在違反無擔保的PHI之後通知受影響的個人，並遵守本通知的條款隱私慣例

我們可以隨時更改我們的通知條款。新通知將對我們當時維護的所有PHI有效。根據您的要求，您可以訪問我們的網站www.scasurgery.com，聯繫您獲得服務的設施，或聯繫隱私官員privacy.officer@scasurgery.com，收到任何修訂後的隱私慣例通知。

我們可以如何使用和披露您的PHI。
我們可能會按照本節所述使用或披露您的PHI。以下是您的PHI的使用和披露類型的示例，SCA在未經您的具體授權的情況下被允許進行。這些例子並不是詳盡無遺，而是描述我們的設施可能使用的類型和披露。當國家或聯邦法律限制所描述的用途或披露之一時，SCA將遵循該州或聯邦法律的要求。以下僅作一般說明。它們並不涵蓋一個類別中的每一個披露的例子。然而，SCA允許使用和披露您的PHI的所有方式將屬於本“隱私慣例通知”中的一個類別。

治療。我們可能會使用PHI來為您提供醫療或服務。我們可能向醫生，護士，技術人員，醫學生或其他涉及您的護理人員披露有關您的醫療信息，例如為您策劃治療方案。我們也可能向SCI披露可能涉及您的醫療保健的SCA以外的個人，例如家庭成員或其他用於提供您護理服務的其他服務。

付款。根據需要，您的PHI將被用於獲取您的醫療保健服務的付款。這可能包括您的健康保險計劃在批准或支付我們為您推薦的醫療保健服務之前可能進行的某些活動，例如確定保險金的資格或保險範圍，審查為您提供的醫療必要性服務，並進行利用審查活動。例如，獲得手術批准可能要求您的相關PHI被披露給您的健康計劃。

醫療保健業務。我們可以根據需要使用或披露您的PHI來支持我們的業務活動。這些活動包括但不限於質量評估活動，員工審查活動，醫學生培訓，許可證，以及進行或安排其他醫療保健業務。例如，您的健康信息可能會向醫務人員，風險或質量改善人員及其他人員披露：

•評估員工績效;
•評估您的病例和類似病例的護理質量和結果;
•了解如何改進我們的設施和服務;要么
•確定如何不斷提高我們提供的醫療保健的質量和效能。

此外，我們可能會在登記處使用登記表，您將被要求籤署您的姓名並指示您的醫生。當您的醫務人員隨時準備看到您時，我們也可以在候診室中以姓名打電話給您。我們可能會根據需要使用或披露您的PHI，與您聯繫以提醒您預約。

我們將與可能對SCA執行各種活動（例如計費或轉錄服務）的第三方“業務夥伴”分享您的PHI。每當我們的設施和業務夥伴之間的安排涉及使用或披露您的PHI時，我們將要求業務夥伴適當地保護它。

2.其他許可和必要的用途和披露，可能會由您的授權或機會對象。您有機會授權或反對使用或披露全部或部分PHI。您隨時可以撤銷您的授權，但您的撤銷只對未來的使用和披露有效，並不會影響依賴於您的授權的任何使用或披露。如果您不在場或無法授權或反對使用或披露PHI，那麼您的醫務人員可以使用專業判斷來確定披露是否符合您的最佳利益。在這種情況下，只有與您的醫療保健相關的PHI才會被披露。在以下情況下，我們可能會使用和披露您的PHI。本“隱私慣例通知”中未描述的其他用途和披露將僅在您的書面授權下進行。

設施目錄。除非您反對，否則我們將在我們的工廠目錄中使用和披露您的姓名，您所在的位置，您的條件（一般來說）和您的宗教信仰。除宗教信仰外，所有這些信息將被透露給要求您的人的姓名。神職人員將被告知你的宗教信仰。

其他涉及您的醫療保健除非您反對，否則我們可能向您的家人，親戚，親戚或任何其他您認同的人透露您的PHI，直接涉及該人參與您的醫療保健。如果您無法同意或反對此類披露，如果我們根據我們的專業判斷確定您的最佳利益，我們可能會披露此類信息。我們可能會使用或披露PHI通知或協助通知家人，個人代表或任何其他負責照顧您的位置的人，了解您的一般狀況或死亡。最後，我們可以向授權的公共或私人實體使用或披露您的PHI，以協助救災工作，並協調家庭或其他參與醫療保健的個人的使用和披露。

此外，除了少數例外，除非您提供書面授權，否則我們不會將您的PHI用於營銷目的，我們不會出售您的PHI。

3.其他許可和必需的用途和披露，可能沒有您的授權或機會對象。在以下情況下，我們可能未經您的授權使用或披露您的PHI：

法律要求我們可能會在法律規定使用或披露的範圍內使用或披露您的PHI。使用或披露將按照法律規定進行，並將限於法律的相關要求。您將根據法律要求通知任何此類用途或披露。

公共衛生。我們可能會將公共衛生活動和目的公開給法律允許的公共衛生當局收集或接收信息。本公告將用於控制疾病，傷害或殘疾。如果公共衛生部門指示，我們也可能會向與公共衛生部門合作的外國政府機構透露您的PHI。

傳染病。如果法律允許，我們可能會洩露您的PHI給可能患有傳染性疾病或可能存在感染或傳播疾病或病症風險的人士。

衛生監督。我們可能會向衛生監督機構披露PHI授權的活動，如審計，調查和檢查。尋求這些信息的監督機構包括監督醫療體系，政府福利計劃，其他政府監管計劃和民權法律的政府機構。

濫用或忽視我們可能會向法律授權的公共衛生當局透露您的PHI，以收到虐待或忽視兒童的報告。此外，如果我們認為您是虐待，忽視或家庭暴力的受害者，我們可能會向被授權接收此類信息的政府機構或機構透露您的PHI。在這種情況下，披露將符合適用的聯邦和州法律的要求。

食品和藥物管理局（“FDA”）。我們可能會向FDA要求的個人或公司透露您的PHI，以報告不良事件和產品缺陷等信息，以便進行產品召回，進行維修或更換，或進行後期營銷監控。

法律訴訟。我們可能會透露法庭或行政命令的PHI。我們也可以透露PHI，以響應傳喚，發現請求或其他合法流程，但只有在作出合理努力以告知您有關請求或獲取保護所請求信息的命令時。
执法。例如，我们可能会为某些执法部门发布PHI，例如法律要求的报告，遵守法庭命令或手令，或报告或回答关于犯罪的问题。

死因裁判官，殡仪主任及器官捐赠。我们可能会向验尸官，殡仪主任或体检主管透露PHI，以便他们履行职责。

研究。我们可能会通过审查研究计划和建立协议的机构审查委员会的研究批准了中国人的PHI，以确保您的PHI的隐私。

正式的联邦和州法律活动，如果我们认为使用或披露是必要的，以防止或减轻对人身或公众的健康或安全的严重威胁，我们可能会透露您的PHI。如果执法机关有必要识别或逮捕个人，披露PHI。

（1）为军事指挥部门所需的活动（2），为了维多利亚事务部确定您的资格资格，或（3）如果您是外国军事人员的外国军事当局。我们也可以向授权的联邦官员披露您的PHI进行国家安全和情报活动，包括向美国总统或其他官员提供保护性服务。

劳动者报酬。您的PHI可能被我们触发，被授权遵守工人赔偿法律和其他类似的法律规定的程序。

需要使用和披露。根据法律，我们必须向您和美国卫生与人类服务部披露，以确定我们是否符合联邦隐私标准的要求。

你的权利以下是关于您对PHI的权利的声明，以及您如何行使这些权利的简要说明。我们有权在某些情况下拒绝您的请求。如果您的请求被拒绝，我们将通知您

访问您的PHI的权利。只要我们维护PHI，您可以检查并获得包含在指定记录集中的您的PHI副本。 “指定记录集”包含您的医疗保健提供者和SCA用于作出决定的医疗和记帐记录以及任何其他记录。然而，根据联邦法律，您不得检查或复制以下记录：心理治疗笔记;合理预期或用于民事，刑事或行政诉讼或诉讼的资料;以及受法律禁止访问PHI的PHI。根据情况，拒绝访问的决定可能是可审查的。如果您要求的信息是以电子方式进行调解的，并且您要求提供电子版本，我们将以您所要求的电子格式和格式提供一份复印件，如果可以以该格式和格式制作信息。如果不能以这种形式和格式预测信息，我们将与您就表格和格式达成协议。

如果您对访问PHI有任何疑问，请联系医疗记录部门。如果您要求提供信息的副本，我们可能会收取与您的请求相关的检索，复制，邮寄和任何其他耗材的费用。您的记录仍然是SCA的财产。

要求限制使用或披露您的PHI的权利。您可以要求我们使用或披露您的PHI的任何部分，以便进行治疗，付款或医疗保健操作。您还可以要求您的PHI的任何部分不会对可能参与您的关心或出于通知目的的家庭成员或朋友表达，如“隐私惯例通知”中所述。您的请求必须说明所要求的具体限制，以及您希望限制哪些人适用。除了以下段落中的规定外，我们不需要同意您的要求。但是，如果我们同意该请求，我们将会履行附件，直到您撤销该协议或通知您。

如果（1）除法律另有要求外，我們將遵守任何限制要求，披露是為了進行付款或醫療保健操作而進行的健康計劃（而不是為了進行治療）;和（2）PHI僅涉及所涉及的醫療保健提供者全額自付的保健用品或服務。 SCA不負責通知隨後的醫療保健提供者您對這些項目和服務的健康計劃的披露的限制請求，因此如果您希望他們遵守相同的限制，您將需要通知其他提供商。

要求限制，您必須以書面形式向SCA發出請求。在您的要求中，您必須告訴我們（1）您想限制什麼信息; （2）您是否要限制我們的使用，披露或兩者兼而有之？和（3）您想要限制的人（例如，向您的配偶披露）。

請求從我們接收保密通信的權利。您有權要求我們以某種方式或某一位置與您溝通醫療事宜。我們將嘗試適應合理的要求。關於請求的依據，我們不會要求您作出解釋。請以書面形式向設施的醫療記錄部門提出請求。

請求修正權。如果您認為我們對您的PHI有錯誤或不完整，您可以要求我們修改信息。在某些情況下，我們可能會否認您提出的修正案。如果我們否認您的修改請求，您有權提出與我們不同意見的聲明，我們可能會對您的陳述作出反駁，並將為您提供任何此類反駁的副本。如果您有關於修改醫療記錄的問題，請聯繫醫療記錄部門。

要求某些披露的會計的權利。您可以要求我們披露您的PHI的清單，但有幾個例外和限制。例如，這項權利不適用於治療，支付或醫療保健業務以外的其他目的的披露，並且不包括我們可能向您，參與護理的家庭成員或朋友，或通知目的的披露。您有權收到有關這些披露的具體信息。要求此列表或披露的會計記錄，您必須以書面形式向SCA隱私官提交請求。您的請求必須說明在請求日期之前不得超過六年的時間段，可能不包括2003年4月14日之前的日期。您在12個月內申請的第一個列表將是免費的。在同一個12個月期間的額外列表中，我們可能會向您收取提供清單的費用。我們將通知您所涉及的費用，您可以選擇在發生任何費用之前撤銷或修改您的請求。

有權通知違約。如果我們發現違反聯邦法律規定的無擔保PHI，您有權被通知。

獲得本通知書的副本的權利。您有權獲得此通知的紙質副本，即使您同意以電子方式收到此類通知。您可以隨時向我們發送此通知的副本。要索取本通知的副本，您可以書面向SCA隱私官提出要求（聯繫方式如下）。

5.問題和投訴。
如果您認為您的隱私權受到我們的侵犯，您可以向我們或與衛生與人類服務部的秘書提出投訴。通知我們的隱私主任您可以向我們提出投訴。我們不會報復您提出投訴。有關投訴流程的進一步信息，或提出任何請求或查詢，您可以聯繫我們的隱私官：

隱私官
外科護理附屬機構
569 Brookwood Village Suite 901
伯明翰，AL 35209
電話：（205）545-2713
電子郵件：privacy.officer@scasurgery.com

本通知於二零零三年四月十四日生效，並於二零一五年四月二十八日修訂。