Patient Privacy

Summary of Notice of Privacy Practices

36 Old Kings Hwy So, Darien, CT 06820
40 Cross Street, Norwalk, CT 06851
131 Kings Hwy No, Westport, CT 06880

Privacy Officer: Terri Sargent, Operations Manager / Phone: (203)845-2069 / Fax: (203)847-1940

The following is a brief summary of your rights and our responsibilities as detailed in the Notice of Privacy Practices.

Uses and Disclosures of Your Health Information: We may use the information we develop and collect for treatment by our practice or disclose the information to others to whom we refer you for treatment, for payment for these services and for certain health care "operations" such as improving the competence and quality of our staff and business planning and management. We may disclose your information to our business associates such as medical transcriptionists, billing services, and others who assist in the operations of our practice. We may call you to remind you of appointments and may leave a message on your answering machine if you have one. We may also disclose information to your family about your location or general condition. If you are available and able, we will ask your consent first. Your medical information may be disclosed without your authorization as required by law, for public health purposes, healthcare oversight, including audits and investigations, judicial and administrative proceedings.

Other Uses and Disclosures: Except as described in the Notice, we will not use or disclose your medical information without your written authorization. You can revoke an authorization at any time, except to the extent that we have already taken action in reliance on the authorization.

Your Health Information Rights: You have a number of rights under state and/or federal law which are subject to the terms and conditions specified in the Notice:

You may request restrictions on certain uses and disclosures of your information

You may request that you receive your information from us in a certain way

You may inspect and copy your medical records

You may request an amendment to any record you believe is inaccurate

You may request an accounting of disclosures made of your records

Changes to the Notice: We reserve the right to change the Notice. If we do so, we will post it in our office and provide a copy upon request.

Complaints: You may file a complaint to our Privacy Official whose name is above or with the federal government as detailed in the Notice. You will not be penalized for filing any complaint.

I hereby acknowledge that I have received/reviewed a copy of Coastal Orthpodaedics’ Summary of Notice of Privacy Practices and that I may request a copy of the entire Notice at any time. I understand that this Summary is for convenience only and is not a substitute for reading the entire Notice and does not modify the terms of the Notice.

Confidentiality Your physician understands the importance of patient confidentiality and is committed to the protection of your personal health information.

All personally identifying information is protected and stored on a secure server.

All information given via the physician consult form or in a conversation with any of our employees is held in complete confidence. Our employees adhere to the strict standards for patient confidentiality set by the American Medical Association and the Health on the Net Foundation.

We do not share any of your personal information with any of our affiliate or associate sites. When you access a site that is not a part of your physician's website or the Medfusion website, you will be notified prior to linking to that site.

We will not release any personally identifying information to anyone unless mandated by federal or state laws. Aggregate statistical summaries may be released to third parties, but these statistics will contain no personally identifiable information.

For technical information regarding confidentiality, please Click here

Information Security: Medfusion, Inc. provides the technical information security services for your physician's website. When you submit your information to your physician's website, that information is converted to a random code. This is called encryption. When the information arrives at its destination, the data is decoded and stored on a secure server. There are two ways of knowing you are connected to a secure server.

1. A little closed padlock or unbroken key will appear on the bottom of your browser's window when you access a secure page. 2. The "http" at the beginning of the URL will change to "https" when you access secure pages.

Other ways we provide Internet security:

Email correspondence and notifications from Medfusion will not contain any medical information or indication of medical treatment.

Our patients and physicians communicate health information through a secure server only. To consult with your physician about health matters, patients must register on their physician's website and communicate through our secure server. When your physician needs to correspond with you, an email will be sent notifying you to logon to your physician's website and read the communication. The notification email contains no