ࡱ> c Z !"#$%&'()*+,-./123456789:;<=>?@ABCDFGHIJKLMNOPQSTUVWXY\]^_`abdeRoot Entry( JrLsMatOST [LsLsMMMN0 ND   FMicrosoft Office Word Document MSWordDocWord.Document.89quST   67 =/7d ,t6HTMatadorObject11  F[Ls[LsOle 1Table 'CompObjq@@@ NormalCJ_HaJmH sH tH DAD Default Paragraph FontRiR  Table Normal4 l4a (k(No List  zk>?Ux Nl'(/`az+fz+/z+z+v:z+z+v:z+z+z+v:z+z+v:z+z+v:z+Gz+Gz+Gz+Gz+Gz+Gz+Gz+Gz+Gz+Gz+v:z+z+v:z+z+v:z+Gz+Gz+Gz+Gz+Gz+sz+v:z+k>?Ux Nl'(/`a@0@0@0@0@0@0@0@0@0@0@0@0@0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@0@0@0@0@0@ 0@ 0@ 0@ 0@ 0@ 0@0@0  8@0(  B S  ?"?z@~aeF }7 $8B yLȤ]Ocf`~6h^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHh88^8`OJQJo(hHh^`OJQJ^Jo(hHoh  ^ `OJQJo(hHh  ^ `OJQJo(hHhxx^x`OJQJ^Jo(hHohHH^H`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHhhh^h`OJQJ^Jo(hHoh88^8`OJQJo(hHh^`OJQJo(hHh  ^ `OJQJ^Jo(hHoh  ^ `OJQJo(hHhxx^x`OJQJo(hHhHH^H`OJQJ^Jo(hHoh^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHopp^p`OJQJo(hH@ @ ^@ `OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hH^`OJQJo(hH  ^ `OJQJ^Jo(hHo  ^ `OJQJo(hHxx^x`OJQJo(hHHH^H`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHeOc}7 yL$8B`~?z@                                                               R:\hM,{# o5z->kHl2S#Y$^eP!=@l/@UnknownGz Times New Roman5Symbol3& z Arial?& Arial Black?5 z Courier New;Wingdings"0h3f3f..!r4d3QHP ?!=2Summary of Privacy PracticesPatrick SullivanPatrick Sullivan(       OlePres000 *OlePres0010)WordDocument E4SummaryInformation( R/ )winspoolCanon i550 (Copy 1)Ne02: LZl)    L#."System#’H9$ -@"Arial Black- 52 PDSummary of Privacy PracticesTNuuN4G'M.'T4&GNNG'T4NN4'NNF- @ !~P- 2 D c@"Arial Black- 2  D 9@"Arial-2 _hDThis summary of our privacy practices contains a condensed version of our Notice of Privacy Practices. >8218ST8!1788!7!18218!82282288882818878827818!288788!H8187C!1821C!82282g2 =DThis information is made available upon request by a patient.>8278!S8782S7888188888788!877828187878 2  D 5@"Arial- 2 6D --22 DDate of Last Revision: 07H887782H8128888 2 zD-!2 D1688 2  D- 2 +D0788 2 D 5- 2 D --12 wDTHIS NOTICE DESCRIBES HOW7>HCHM=HCHCCHGCCCHKbR2 w/D MEDICAL INFORMATION ABOUT YOU MAY BE USED AND sSCHHB8H=NHSC>NHCCNG>BNHSCBCCHCCGCHHd2 _;DDISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. tHCH8NCCHCHHHNaBNHHCHNB>CGHCCC>N>HBH=MHSC>NH 2 D 542 ]DPLEASE REVIEW IT CAREFULLY.sC8CBCCHCB@b>HCHC=H88B 2 ]! D 6- 2 D --2 0gDWe understand that your medical information is personal to you, and we are committed to protecting the a77878!287888178!T782878!T788288!28788188877G88!828ST8887!8828778%2 Dinformation about88!S88887882 VD you. As our patient, we create medical records about your health, our care for you, 188C288!8888G82!888T7828!828!818788188!788778!27!88!1882 fDand the services and/or items we provide to you as our patient. By law, we are required to make sure 8888728!12828887!8T2G88!818871888188!8878C18GG88!8!878!888T82728!8_2 8Dthat your protected health information is kept private. 88188!8 88288878878!T78821888!188 2 6 D 6- 2 D --2 \ DHow will wH8GGGg2 \=De use or disclose your information? Here are a few examples:88288!822828188!78 T8778H8!88!878G818T882 2 \ D 5- 2 D -@Symbol- 2 .D*@"Arial- 2 .D l+2 .,DFor medical treatment83M33.333M33 2 .D 0D'- 2 D*- 2 D l>2 ,"DTo obtain payment for our services92333333-M32332.2-.3. 2 D 1D'- 2 D*- 2 D l.2 ,DIn emergency situations32M3433.-.3233. 2 D 0D'- 2 | D*- 2 | D lM2 | ,,DFor appointment and patient recall reminders8333333M3333233333.32M333. 2 | MD 0D'- 2 D*- 2 D lp2 ,CDTo run our Practice more efficiently and ensure all our patients re 923233=3-.3M322.32-33333.323333333-2&2 w Dceive quality care.3-3432-.33 2 ;D 1D'- 2 [ D*- 2 [ D l2 [ , DFor research833.33.3 2 [ 5D 0D'- 2 D*- 2 D lO2 ,-DTo avert a serious threat to health or safetyD923-32.333-233333323.23- 2 D 1D'- 2 ; D*- 2 ; D l72 ; ,DFor organ and tissue donation832433332..32332333 2 ; D 1D'- 2 D*- 2 D l>2 ,"DFor workers compensation programs83A3/2..2M333.2333233M. 2 D 0D'- 2  D*- 2  D ly2  ,IDIn response to certain requests arising out of lawsuits or other disputes33.333.32.3332433-.2.333323A.3.22333.333. 2  b D 0D'- 2 { D --D2 &DIf you believe your privacy rights hav18888818188!8!2821!782881q2 RDDe been violated, you may file a complaint with the Practice or with 8878818878188T817818T888G878C!82288!G82 ] fDthe Secretary of the Department of Health and Human Services. To file a complaint with the Practice, 88B82!88!1888G888!T787H888778H8S88C8!1282=77818S888G878C!82272 VDcontact our office manager. All complaints must be submitted in writing. You will no2888178!727S87878!C27T8872S8278278T888G!87B88G88(2 Dt be penalized for i8877881888!(2 CDfiling a complaint.i87818S888 2 CD 5- 2 D --2 _DYou have certain rights regarding the information we maintain about you. These rights include:B88881828!87!782!878!8878878!S888G8T87888878188=8827!78282888 2 gD 5- 2 zD -- 2 D*- 2 D l72 ,DThe right to inspect and copy9324323.33.333.33- 2 D 2D'- 2 WD*- 2 WD l&2 W,DThe right to amend9324323M233 2 W.D 0D'- 2 D*- 2 D lI2 ,)DThe right to an accounting of disclosuresf932432332..3332323..3.33. 2 D 0D'- 2 7D*- 2 7D l52 7,DThe right to request restric9324322432.3-.2 7ZDtions33. 2 7D 1D'- 2 D*- 2 D lG2 ,(DThe right to a paper copy of this notice93243233332.33-23.23.3 2 DD 0D'@Symbol- 2 D&- 2 D p-S2 ,0DThe right to request confidential communications9324322432..323333.3LM33.333.- 2 D ,D' 2 qD --2 cDFor more information about these disclosures and rights, please see the detailed Notice of Privacy e=8!T8!778 T87878887828822828!82888!782888182788888888H8187C!1831A2 S$DPractices that follows this summary.C!822828888G28228SS8!1 2 S5D 7-NANI LZLZl)    L#."System#’9$ -@"Arial Black- 52 PDSummary of Privacy PracticesTNuuN4G'M.'T4&GNNG'T4NN4'NNF- @ !~P- 2 D c@"Arial Black- 2  D 9@"Arial-2 _hDThis summary of our privacy practices contains a condensed version of our Notice of Privacy Practices. >8218ST8!1788!7!18218!82282288882818878827818!288788!H8187C!1821C!82282g2 =DThis information is made available upon request by a patient.>8278!S8782S7888188888788!877828187878 2  D 5@"Arial- 2 6D --22 DDate of Last Revision: 07H887782H8128888 2 zD-!2 D1688 2  D- 2 +D0788 2 D 5- 2 D --12 wDTHIS NOTICE DESCRIBES HOW7>HCHM=HCHCCHGCCCHKbR2 w/D MEDICAL INFORMATION ABOUT YOU MAY BE USED AND sSCHHB8H=NHSC>NHCCNG>BNHSCBCCHCCGCHHd2 _;DDISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. tHCH8NCCHCHHHNaBNHHCHNB>CGHCCC>N>HBH=MHSC>NH 2 D 542 ]DPLEASE REVIEW IT CAREFULLY.sC8CBCCHCB@b>HCHC=H88B 2 ]! D 6- 2 D --2 0gDWe understand that your medical information is personal to you, and we are committed to protecting the a77878!287888178!T782878!T788288!28788188877G88!828ST8887!8828778%2 Dinformation about88!S88887882 VD you. As our patient, we create medical records about your health, our care for you, 188C288!8888G82!888T7828!828!818788188!788778!27!88!1882 fDand the services and/or items we provide to you as our patient. By law, we are required to make sure 8888728!12828887!8T2G88!818871888188!8878C18GG88!8!878!888T82728!8_2 8Dthat your protected health information is kept private. 88188!8 88288878878!T78821888!188 2 6 D 6- 2 D --2 \ DHow will wH8GGGg2 \=De use or disclose your information? Here are a few examples:88288!822828188!78 T8778H8!88!878G818T882 2 \ D 5- 2 D -@Symbol- 2 .D*@"Arial- 2 .D l+2 .,DFor medical treatment83M33.333M33 2 .D 0D'- 2 D*- 2 D l>2 ,"DTo obtain payment for our services92333333-M32332.2-.3. 2 D 1D'- 2 D*- 2 D l.2 ,DIn emergency situations32M3433.-.3233. 2 D 0D'- 2 | D*- 2 | D lM2 | ,,DFor appointment and patient recall reminders8333333M3333233333.32M333. 2 | MD 0D'- 2 D*- 2 D lp2 ,CDTo run our Practice more efficiently and ensure all our patients re 923233=3-.3M322.32-33333.323333333-2&2 w Dceive quality care.3-3432-.33 2 ;D 1D'- 2 [ D*- 2 [ D l2 [ , DFor research833.33.3 2 [ 5D 0D'- 2 D*- 2 D lO2 ,-DTo avert a serious threat to health or safetyD923-32.333-233333323.23- 2 D 1D'- 2 ; D*- 2 ; D l72 ; ,DFor organ and tissue donation832433332..32332333 2 ; D 1D'- 2 D*- 2 D l>2 ,"DFor workers compensation programs83A3/2..2M333.2333233M. 2 D 0D'- 2  D*- 2  D ly2  ,IDIn response to certain requests arising out of lawsuits or other disputes33.333.32.3332433-.2.333323A.3.22333.333. 2  b D 0D'- 2 { D --D2 &DIf you believe your privacy rights hav18888818188!8!2821!782881q2 RDDe been violated, you may file a complaint with the Practice or with 8878818878188T817818T888G878C!82288!G82 ] fDthe Secretary of the Department of Health and Human Services. To file a complaint with the Practice, 88B82!88!1888G888!T787H888778H8S88C8!1282=77818S888G878C!82272 VDcontact our office manager. All complaints must be submitted in writing. You will no2888178!727S87878!C27T8872S8278278T888G!87B88G88(2 Dt be penalized for i8877881888!(2 CDfiling a complaint.i87818S888 2 CD 5- 2 D --2 _DYou have certain rights regarding the information we maintain about you. These rights include:B88881828!87!782!878!8878878!S888G8T87888878188=8827!78282888 2 gD 5- 2 zD -- 2 D*- 2 D l72 ,DThe right to inspect and copy9324323.33.333.33- 2 D 2D'- 2 WD*- 2 WD l&2 W,DThe right to amend9324323M233 2 W.D 0D'- 2 D*- 2 D lI2 ,)DThe right to an accounting of disclosuresf932432332..3332323..3.33. 2 D 0D'- 2 7D*- 2 7D l52 7,DThe right to request restric9324322432.3-.2 7ZDtions33. 2 7D 1D'- 2 D*- 2 D lG2 ,(DThe right to a paper copy of this notice93243233332.33-23.23.3 2 DD 0D'@Symbol- 2 D&- 2 D p-S2 ,0DThe right to request confidential communications9324322432..323333.3LM33.333.- 2 D ,D' 2 qD --2 cDFor more information about these disclosures and rights, please see the detailed Notice of Privacy e=8!T8!778 T87878887828822828!82888!782888182788888888H8187C!1831A2 S$DPractices that follows this summary.C!822828888G28228SS8!1 2 S5D 7-q` bjbjqPqP 4::D "i"r !!!!!!!$#hC&" " #"   ! ! ! 0@s p !9"0i" & &(!&!T "" i" """ """  Summary of Privacy Practices This summary of our privacy practices contains a condensed version of our Notice of Privacy Practices. This information is made available upon request by a patient. Date of Last Revision: 07-16-07 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. We understand that your medical information is personal to you, and we are committed to protecting the information about you. As our patient, we create medical records about your health, our care for you, and the services and/or items we provide to you as our patient. By law, we are required to make sure that your protected health information is kept private. How will we use or disclose your information? Here are a few examples: For medical treatment To obtain payment for our services In emergency situations For appointment and patient recall reminders To run our Practice more efficiently and ensure all our patients receive quality care For research To avert a serious threat to health or safety For organ and tissue donation For workers compensation programs In response to certain requests arising out of lawsuits or other disputes If you believe your privacy rights have been violated, you may file a complaint with the Practice or with the Secretary of the Department of Health and Human Services. To file a complaint with the Practice, contact our office manager. All complaints must be submitted in writing. You will not be penalized for filing a complaint. You have certain rights regarding the information we maintain about you. These rights include: The right to inspect and copy The right to amend The right to an accounting of disclosures The right to request restrictions The right to a paper copy of this notice The right to request confidential communications For more information about these disclosures and rights, please see the detailed Notice of Privacy Practices that follows this summary.  > ? '(_aǶǶ hhePCJOJQJ^JaJ hhePCJOJQJ^JaJhePOJQJ^Jh$^heP>*CJOJQJaJheP>*CJOJQJaJk > ? U x  N l '( & FgdePgdeP$a$gdeP/`a & FgdePgdeP 21h:pz->1 =!"#$% Oh+'0 $ D P \hpx Summary of Privacy PracticesPatrick SullivanNormalPatrick Sullivan2Microsoft Office Word@@'s@'s.DocumentSummaryInformation8[CompObjU՜.+,0 hp|    Summary of Privacy Practices Title  t6HT {w{  qq !  t6HTMO MO z+ 3z+ 3 Times New Roman  7 =/77 =/7d ( JrMicrosoft Works MSWorksWPDoc9q