Privacy Practices

Your Information. Your Rights. Our Responsibilities.

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.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
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.

Ask us to correct your medical record

You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information

You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

You can complain if you feel we have violated your rights by contacting us using the information at the end of this document.
You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

Share information with your family, close friends, or others involved in your care
Share information in a disaster relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

Our Uses and Disclosures

How do we typically use or share your health information? We typically use or share your health information in the following ways:

Treat you-We can use your health information and share it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization-We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

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

Example: We give information about you to your health insurance plan so it will pay for your services.

For marketing purposes. Example: We use third party services to communicate with you for general marketing and reviews. By law, the providers of these services are required to agree to a Business associate agreement which restricts them from selling any patient information that we share with them.

WE NEVER SELL YOUR INFORMATION.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

1. Help with public health and safety issues

a. We can share health information about you for certain situations such as:

i. Preventing disease

ii. Helping with product recalls

iii. Reporting adverse reactions to medications

iv. Reporting suspected abuse, neglect, or domestic violence

v. Preventing or reducing a serious threat to anyone’s health or safety

2. Do research-We can use or share your information for health research.

3. Comply with the law-We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

4. Address workers’ compensation, law enforcement, and other government requests

a. We can use or share health information about you:

i. For workers’ compensation claims

ii. For law enforcement purposes or with a law enforcement official

iii. With health oversight agencies for activities authorized by law

iv. For special government functions such as military, national security, and presidential protective services

5. Respond to lawsuits and legal actions-We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occur s that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it upon request.
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

State of Oregon privacy policies(ORS 192.558)

A health care provider or state health plan:

(1)May use or disclose protected health information of an individual in a manner that is consistent with an authorization provided by the individual or a personal representative of the individual.

(2)May use or disclose protected health information of an individual without obtaining an authorization from the individual or a personal representative of the individual:

(a)For the provider’s or plan’s own treatment, payment or health care operations; or

(b)As otherwise permitted or required by state or federal law or by order of the court.

(3)May disclose protected health information of an individual without obtaining an authorization from the individual or a personal representative of the individual:

(a)To another covered entity for health care operations activities of the entity that receives the information if:

(A)Each entity has or had a relationship with the individual who is the subject of the protected health information; and

(B)The protected health information pertains to the relationship and the disclosure is for the purpose of:

(i)Health care operations as listed in ORS 192.556 (Definitions for ORS 192.553 to 192.581) (4)(a) or (b); or

(ii)Health care fraud and abuse detection or compliance;

(b)To another covered entity or any other health care provider for treatment activities of a health care provider;

(c)To another covered entity or any other health care provider for the payment activities of the entity that receives that information; or

(d)In accordance with ORS 192.567 (Disclosure without authorization form) or 192.577 (Disclosure of information concerning adult in custody of Department of Corrections). [Formerly 192.520; 2015 c.473 §5; 2017 c.484 §4]

(End of State of Oregon Privacy Policies- See https://oregon.public.law/statutes/ors_192.558 for more information-Accessed on 2/3/2025)

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

This notice applies to Audiology Consultants of Southern Oregon dba Roseburg Audiology Center (1931 NW Mulholland Drive, Roseburg, OR 97470) and Hearing Associates of Florence(1901 Hwy 101 Ste. A, Florence, OR 97439). If you have any questions, comments, or concerns feel free to call our business office at 541-672-8868 or e-mail Chad Harris(Practice Manager and Compliance officer) at [email protected].

Effective Date of this document: 03-6-2025

Website Privacy Notice

Your privacy on the Internet is of the utmost importance to us. At Roseburg Audiology Center and Hearing Associates of Florence, we want to make your experience online satisfying and safe. Because we gather certain types of information about our users including in some cases protected information under the Health Insurance Portability & Accountability Act of 1996 (“HIPAA”). For any individual in Canada, we may gather information about our users that is protected information under the Canadian Personal Information Protection and Electronic Documents Act (“PIPEDA”).

HIPAA provides penalties for covered entities that misuse personal health information. We are required by law to maintain the privacy of your protected healthcare information and to provide yo u with this notice of our legal duties and our privacy practices. HIPAA gives you, the patient, the right to understand and control how your protected health information (“PHI”) is used. Similarly, PIPEDA protects the disclosure of information as well.

The information you provide is safeguarded. This Privacy Policy discloses what information we gather and how we use it. It applies to information we collect on this Website, including through electronic messages between you and the Website (for example, when you submit a message using our “Customer Service/Feedback” form or when you complete the “Request an Appointment” form). It does not apply to information collected by us offline or through other means, or to information collected by third parties, including through any application or content that may link to or be accessible from this Website. By accessing or using this Website, you agree to this Privacy Policy. Please review it carefully.

You may have the following rights with respect to your PHI:

The right to request restrictions on certain uses and disclosures of PHI, including those related to disclosures of family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to honor a request restriction except in limited circumstances which we shall explain if you ask. If we do agree to the restriction, we must abide by it unless you notify us in writing.
You can advise us of the best location to contact you to protect your private information.
You can request a copy of your medical record in writing.
You can request an amendment of your PHI. This request must be done in writing and will be honored at our discretion.
We keep a log of disclosures of your medical information for the past six years and you can request a copy.
We will notify you if a breach of your protected health information occurs.

This privacy notice discloses the privacy practices for https://roseburgaudiology.com. It will notify you of the following:

What personally identifiable information is collected from you through the website, how it is used and with whom it may be shared.
What choices are available to you regarding the use of your data.
The security procedures in place to protect the misuse of your information.
How you can correct any inaccuracies in the information.

Information Collection, Use, and Sharing

In compliance with federal and state privacy laws including HIPAA and PIPEDA, written authorization by the patient or legal guardian is required before we can release records containing PHI for reasons other than treatment, payment, and healthcare operations. If you authorize the release your records, you may revoke such authorization in writing, and we will honor your request from the date we receive your written request forward.

We are the sole owners of the information collected on this site. We only have access to collect information that you voluntarily give us via email or other direct contact from you. We will not sell or rent this information to anyone.

We will use your information to respond to you, regarding the reason you contacted us. We will not share your information with any third party outside of our organization, other than as necessary to fulfill your request, e.g. to ship an order.

Unless you ask us not to, we may contact you via email in the future to tell you about specials, new products or services, or changes to this privacy policy.

Your Access to and Control Over Information

You may opt out of any future contacts from us at any time. You can do the following at any time by contacting us via the email address or phone number given on our website:

See what data we have about you, if any.
Change/correct any data we have about you.
Have us delete any data we have about you.
Express any concern you have about our use of your data.

Security

We take precautions to protect your information. When you submit sensitive information via the website, your information is protected both online and offline.

While we use encryption to protect sensitive information transmitted online, we also protect your information offline. Only employees who need the information to perform a specific job (for example, billing or customer service) are granted access to personally identifiable information.

The computers/servers in which we store personally identifiable information are kept in a secure environment.

Information Gathered and Tracked

Information that users provide through optional, voluntary submissions. This information may include personal information, such as your name, phone number, email address, state and zip code. We collect this information to respond to requests from users, customize our features for individual visitors who are our customers and to notify customers about updates to our site and products or services.

Information that we collect automatically as you navigate the Website. This information may include usage details, IP addresses and information collected through tracking technologies such as cookies and web beacons. Information Audiology Design gathers through aggregated tracking is used to determine which areas of our sites users like and don’t like based on traffic to those areas. We do not track what individual users read, but rather how well each page performs overall. We collect this information in order to determine how to create the best experience for our customers. We may track search terms entered in our Search function as one of many measures of what interests our users, but this tracking is never associated with an individual user.

Cookies and Automatic Data Collection

We use “cookies” on this site. A cookie is a piece of data stored on a site visitor’s hard drive to help us improve your access to our site and identify repeat visitors to our site. For instance, when we use a cookie to identify you, you would not have to log in a password more than once, thereby saving time while on our site. Cookies can also enable us to track and target the interests of our users to enhance the experience on our site. Usage of a cookie is in no way linked to any personally identifiable information on our site.

Some of our business partners may use cookies on our site (for example, Facebook).

However, we have no access to or control over these cookies.

Our Website permits you to use a third party social networking platform such as Facebook, X, Instagram and TikTok. This includes use of social media plugins such as Facebook “Like”, Tweet and Google “+1” buttons, etc. When you use social networking platforms and plugins, you share your information with them and their privacy policy applies to disclosure of such information. In addition, these social networking platforms may collect information about you, including your use of the Website. Such services may allow your activity to be monitored across multiple websites for purposes of delivering more targeted advertising. Please note that their own privacy policies apply and we encourage you to read them. We may add new social networking plugins and buttons to our Websites from time to time.

Sharing

We share aggregated demographic information with our partners and advertisers. This is not linked to any personal information or PHI that can identify any individual person.

Links

This website contains links to other sites. Please be aware that we are not responsible for the content or privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of any other site that collects personally identifiable information.

Healthcare Disclaimer

The information presented on this Website is not intended to be medical advice and should not be relied upon as such. If you suspect a hearing problem, we strongly urge you to consult with a qualified physician or hearing professional.

Children’s Privacy

Our Services do not address anyone under the age of 13. We do not knowingly collect personal identifiable information from children under 13. In the case we discover that a child under 13 has provided us with personal information, we immediately delete this from our servers. If you are a parent or guardian and you are aware that your child has provided us with personal information, please contact us so that we will be able to take necessary actions.

Your California privacy rights

California Civil Code § 1798.83 permits our visitors who are California residents to request certain information regarding our disclosure of personal information to third-parties for their direct marketing purposes. To make such a request, please contact us and indicate whether you are a California resident.

California law requires us to let you know how we respond to web browser “Do Not Track” signals. Our Website does not currently support “Do Not Track” codes. That is, Roseburg Audiology Center and Hearing Associates of Florence does not currently respond to or take any action with regard to “Do Not Track” requests.

Changes to This Privacy Policy

We may update our Privacy Policy from time to time. Thus, we advise you to review this page periodically for any changes. We will notify you of any changes by posting the new Privacy Policy on this page. These changes are effective immediately, after they are posted on this page.

Contact Us

If you have questions about the Terms of Use, Privacy Policy or your experience with any of our sites, please contact us via our website.