Notice of Privacy Practices for Feathers ‘N Flight

(HIPAA Notice)

Effective Date: July 18, 2012


Does This Notice Apply to You?

Current HIPAA laws apply only to a health care provider who is electronically transmitting health information to a qualified health plan.  In most cases, this will *not* apply to my professional relationship with clients.  You may find the current definition of entities covered under HIPAA law at the US Department of Health and Human Services website here:

Even if our association does not fall under HIPAA laws, however, please rest assured that the policies as outlined below are also my personal policies when it comes to safeguarding your information.

Your Health Information Rights

Although your health record is the physical property of the healthcare provider that compiled it, the information belongs to you. You have the right to:
• request a restriction on certain uses and disclosures of your information
• obtain a paper copy of the notice of information practices upon request
• inspect and obtain a copy of all records I keep for you
• amend these records
• obtain an accounting of disclosures of your health information
• request communications of your health information by alternative means or at alternative locations
• revoke your authorization to use or disclose health information except to the extent that action has already been taken

My Responsibilities

As a services provider, I am required to:
• maintain the privacy of your health information
• provide you with a notice as to my legal duties and privacy practices with respect to information I collect and maintain about you
• abide by the terms of this notice
•  notify you if I am unable to agree to a requested restriction
•  accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

I reserve the right to change my practices and to make the new provisions effective for all protected health information I maintain. Should my information practices change, I will mail a revised notice to the address you've supplied me. I will not use or disclose your health information without your authorization, except as described in this notice.

Examples of Disclosures for Treatment, Payment and Health Operations:

•  I will use your health information for treatment purposes.

For example: Information obtained by a physical therapist, acupuncturist, chiropractor, or other member of your healthcare team may be recorded in your record and used to determine the course of massage treatment or personal training techniques that should work best for you. I may document in your record the treatments, techniques, and observations from each session in order to analyze how you are responding to our sessions.

At your request and by your authorization ONLY, I will provide subsequent healthcare providers with information from these records that may assist him or her in treating you.

•  I will use your health information for payment purposes.

For example: A bill may be sent to you or a third-party payer such as an insurance company, the Medicare program or any other organization, person or program that may be responsible for paying for services. The information on or accompanying the bill may include information that identifies you, as well as your appointment dates, treatment types, session durations, and any supplies used.

•  I will use your health information for regular health operations.

For example: I may use information in your records to assess the treatments and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the care and service I provide.

Notification: I may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition.

Communication with family: I may, using my best judgement, disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person's involvement in your care or payment related to your care.

Research: I may disclose information 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 health information.

Funeral directors: I may disclose health information to funeral directors consistent with applicable law to carry out their duties.

Organ procurement organizations: Consistent with applicable law, I may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Marketing: I may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you or otherwise provide information about additional services or health care products you may find useful.

Fund raising: I may contact you as part of a fund-raising effort.

Food and Drug Administration (PDA): I may disclose to the PDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Workers' compensation: I may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public health: As required by law, I may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Legal Matters: In the event of a claim, litigation or other legal proceeding or contemplated legal matter, I may disclose health information to my attorneys and individuals or organizations working
for them.

Law enforcement: I may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that I have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

For More Information or to Report a Problem
If have questions and would like additional information, you may contact Shasta Bates, at

Feathers ‘N Flight
3822 S Ventura St
Aurora, CO 80013
or (720) 260 0512.

If you believe your privacy rights have been violated, you can file a complaint with Shasta Bates (myself)  or with the secretary of Health and Human Services. There will be no retaliation for filing a complaint.

Other Uses of Protected Health Information
Other uses and disclosures of protected health information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide me permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time.

If you revoke your permission, I will no longer use or disclose protected health information about you for the reasons covered by your written authorization. You understand that I am unable to take back any disclosures I have already made with your permission, and that I am required to retain any existing records of the care that I have provided to you.