HIPAA 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.

Who Will Follow This Notice
This notice describes the practices of All Women’s Health Center (AWHC St Pete), Women’s Obstetrical & Gynecology of Countryside, Inc., (WOBGYN), All Women’s Health Center of North Tampa, Inc (AWHC Tampa), All Women’s Health Center of Tampa, Inc (AWHC Tampa), All Women’s Health Center of Sarasota, Inc (AWHC Sarasota); Ft. Myers Women’s Health Center, Inc, (FMWHC), Lakeland Women’s Health Center, Inc, (LWHC), All Women’s Health Center of Gainesville, Inc (AWHC Gainesville), All Women’s Health Center of Jacksonville, Inc (AWHC Jacksonville), All Women’s Health Center of Orlando, Inc (AWHC Orlando) and those of:

• Any health care professional authorized to enter information into your medical chart. If a member of the Medical Staff or credentialed Allied Health Professional has not elected to be governed by this Notice, the law requires them to provide you with a copy of their own Notice of Privacy Practices. This joint Notice of Privacy Practices was created for information management purposes only. No joint venture or other relationship between AWHC / WOBGYN / FMWHC / LWHC and its Medical Staff and its credentialed Allied Health Professional is created or implied.
• All departments and units AWHC / WOBGYN / FMWHC / LWHC;
• Any member of a volunteer group we allow to help you while you are in our offices;
• All employees, staff and other personnel;
• All Women’s Health Centers, Women’s Obstetrical & Gynecological Center of Countryside Inc, Ft Myers Women’s Health Center Inc and Lakeland Women’s Health Center Inc. All these entities, sites and locations follow the terms of this notice. In addition, these entities, sites and locations may share medical information with each other for treatment, payment or healthcare operation purposes described in this Notice.

Our Pledge Regarding Medical Information

We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at our facilities. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by our facilities, whether made by our personnel or your personal doctor. Your personal doctor may have different policies or notices regarding the doctor’s use and disclosure of your medical information created in the doctor’s office or clinic. This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information. We are required by law to:

• Make sure that medical information that identifies you is kept private;
• Give you this notice of our legal duties and privacy practices with respect to medical information about you;
  and
• Follow the terms of the Notice that are currently in effect

How We May Use and Disclose Medical Information About You
The following categories describe different ways that we use and disclose your medical information. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

For Treatment: We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to physicians, nurses, technicians, healthcare students, or other personnel who are involved in your care. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. Our healthcare facilities also may share medical information about you in order to coordinate the different things you need, such as prescriptions, lab work and ultrasounds. We also may disclose medical information about you to people outside our facilities who may be involved in your medical care after you leave our facility, such as family members or others we use to provide services that are part of your care.

For Payment: We may use and disclose medical information about you so the treatment and services you receive at our facility may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about the services you received so your health plan will pay us or reimburse you for those services. We may also tell your health plan about any treatments you may need to receive any prior approvals or to determine whether your plan will cover the treatment. However, if you pay for a health care item or service “out-of- pocket” in full, you may request that we will not disclose your health information to your health plan or insurance company.

For Health Care Operations: We may use and disclose medical information about you for health care operations. These uses and disclosures are necessary to run our healthcare facilities and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical information about many patients to decide what additional services we should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians and other personnel for review and learning purposes. We may also combine the medical information we have with medical information from other healthcare providers to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of medical information so others may use it to study health care and healthcare delivery without learning who the specific patients are.

Appointment Reminders: We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at our facilities. Treatment Alternatives: We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

Individuals Involved in Your Care or Payment of Your Care: We may release medical information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. We may also tell your family or friends about your condition and that you are a patient in our facility. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location. You may restrict some or all of these disclosures by requesting the restriction in writing. Your Nurse or other patient care provider can assist you in this request. You can also make the request in writing to: Clinical Management Corporation of America, PO Box 5271, Clearwater, Florida 33758-9878. Please be sure to specify what office your had services or treatment rendered; AWHC (city), WOBGYN, FTMWHC or LWHC.

As Required by Law: We will disclose medical information about you when required to do so by federal, state of local law.

To Avert a Serious Threat to Health or Safety: We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat. Organ and Tissue Donation: If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

Military and Veterans: If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.

Workers’ Compensation: We may release medical information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness. Health information related to services rendered to our employees at our facilities will be released to All Women’s Health Centers, Women’s Obstetrical & Gynecological Center of Countryside, Inc, Ft Myers Women’s Health Center, Inc, and Lakeland Women’s Health Center, Inc., if the services involve work-related medical surveillance and/ or work-related illness or injuries.

Public Health Risks: We may disclose medical information about you for public health activities. These activities
generally include the following:

• To prevent or control disease, injury or disability;
• To report births and deaths;
• To report child or vulnerable adult abuse or neglect;
• To report reactions to medications or problems with products;
• To notify people of recalls of products they may be using;
• To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a
  disease or condition.

Health Oversight Activities: We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections and licensure.
These activities are necessary for the government to monitor the health care system, government programs and compliance with civil rights laws.

Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protective the information requested.

Law Enforcement: We may release medical information if asked to do so by a law enforcement official in response to a court order, subpoena, warrant, summons or similar process, subject to all applicable legal requirements. Coroners, Medical Examiners and Funeral Directors: We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or to determine the cause of death. We may also release medical information about patients to funeral directors as necessary to carry out their duties.

National Security and Intelligence Activities: We may release medical information about you to authorized officials for intelligence, counterintelligence and other national security activities authorized by law.

Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official.
Information Not Personally Identifiable: We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.

Minors and Persons with Guardians
This Notice of Privacy Practices also applies to minors and incapacitated adults. Minors and incapacitated adults enjoy the same basic privacy protections as those listed above for their health information. However, because by law minors and incapacitated adults cannot make health care decisions for themselves, either a parent or legal guardian must make medical decisions on their behalf. Consequently, because parents and legal guardians make health care decisions on behalf of minors or incapacitated adults, parents or legal guardians can authorize the use and disclosure of minors’ or incapacitated adults’ health information as if the parents or legal guardians were in the minor’s or incapacitated adults’ shoes. When making health care decisions on behalf of minors or incapacitated adults, parents or guardians also hold all of the rights listed in this Notice related to the protection of such health information, including the right to inspect and copy and the right to amend.

While oftentimes a minor’s health care decisions are made by a parent or legal guardian, there are certain situations where minors can make their own healthcare decisions independent of parental or legal guardian knowledge or consent. Such situations are heavily regulated by law and include minors who have become emancipated, minors who are donating blood or tissue samples and minors who are independently seeking examination and treatment for a sexually transmissible disease. It is important to note that when making such an independent health care decision, only the minor can authorize the use and disclosure of the minor’s health information with respect to the independent health care decision. Moreover, the minor holds all of the rights listed in the Notice related to the protection of health information concerning such an independent health care decision. However, if the minor elects to inform the parent or legal guardian and obtain parental or guardian consent for the independent health care decision, then all of the privacy rights regarding the health information for the independent health care decision may revert back to the parent or legal guardian.

There are also certain situations where adults other than the parent or legal guardian can access, use and/or disclose a minor’s health information without the consent of the parent or legal guardian. These situations usually occur where the law recognized that the health or safety of the minor is in danger and access to or use and disclosure of health information without appropriate authorization is necessary to appropriately protect the minor. Such situations include minors who are suffering from emergency medical conditions, minors who have independently sought contraceptive information and services, and minors who are victims of child abuse, abandonment or neglect.

Abortions for Minors
We may, under some circumstances, be required by law to give notice to the parents or legal guardians of minors who intend to utilize our abortion services. Please feel free to seek further information from your physician or medical office staff.

Your Rights Regarding Medical Information About You Right to Inspect and Copy: With a few exceptions, you have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records. To inspect and copy medical information that me be used to make decisions about you, please contact your Nurse or other office care provider staff. You may submit your request in writing to: Clinical Management Corporation of America, PO Box 5271, Clearwater, Florida 33758-9878; please be sure to include which office you had services or treatment rendered: AWHC (city), WOBGYN, FTMWHC, and LWHC. If you request a copy of the information, we may charge a reasonable fee for the costs of copying, mailing or other supplies associated with your request.

Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for AWHC (city), WOBGYN, FTMWHC or LWHC. To request an amendment, your request must be made in writing and submitted to: Clinical Management Corporation of America, PO Box 5271, Clearwater, Florida 33758-9878. *Please note which office you received services or treatment; AWHC (city), WOBGYN, FTMWHC or LWHC. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

Was not created by us, unless the person or entity that created the information is no longer available to make the amendment:

• Is not part of the medical information kept by or for AWHC, WOBGYN, FTMWHC or LWHC;
• Is not part of the information which you would be permitted to inspect or copy; or
• Is accurate and complete. We will respond to your request in writing within (60) sixty days of your written
  request.

Right to An Accounting of Disclosures: You have the right to ask for a list of the disclosures of your health information we have made during the previous six years, but the request cannot include dates before April 14, 2003. This listing will include the date of each disclosure, who received the disclosed health information, a brief description of the health information disclosed and the reason for the disclosure. The listing will not include the following disclosures:

• Disclosures made for the purpose of treatment, payment or healthcare operations, or disclosures of directory information or disclosures made to family or responsible caregivers as described above;
• Disclosures made directly to you;
• Disclosures made based on a valid authorization from you or from your legally authorized representative;
• Oral or incidental disclosures;
• Disclosures made for purposes of national security, or to correctional institutions or law enforcement officers as described above;
• Disclosures made prior to April 14, 2003.

You must request this listing of disclosures by submitting your request in writing to: Clinical Management Corporation of America; PO Box 5271, Clearwater, Florida 33758-9878. *Please note which office you had services or treatment rendered: AWHC (city), WOBGYN, FTWHC or LWHC. We will provide you with the list within (60) sixty days of receipt of your request, unless you agree to a (30) thirty-day extension. There is no charge to you for the list, unless you request such a list more than once a year.

Right to Notification of Breach: You have the right to receive written notification of a breach where your unsecured health information has been accessed, acquired, used or disclosed to an unauthorized person as a result of such breach in a manner that compromises the security or privacy of your health information. Unless specified by you to receive the notification by electronic mail, we will provide such written notification by first-class mail or, if necessary, by such other substituted forms of communication allowable under the law.

Right to Request Restrictions: You have the right to ask for restrictions on how your health information is used or to whom your information is disclosed, even if the restriction affects your treatment, or our payment or health care operation activities. However, we are not required to agree to your requested restriction and, even if we agree to the requested restriction, we are permitted to use your information without complying with the restriction if necessary to treat you in an emergency situation. To request restrictions, please notify your Nurse or other office staff. Please submit your request in writing to: Clinical Management Corporation of America, PO Box 5271, Clearwater, Florida 33758-9878. *Please note which office you had services or treatment rendered: AWHC (city), WOBGYN, FTWHC or LWHC. 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. Although we are generally not required to agree to requested restrictions, we are required to keep your health information confidential if you pay for a health care service or treatment “out-of-pocket” in full, and you request that we not disclose health information related to that health care service or treatment.

Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing to: Clinical Management Corporation of America, PO Box 5271, Clearwater, Florida 33758-9878. *Please note which office you had services or treatment rendered: AWHC (city), WOBGYN, FTWHC or LWHC. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to a Paper Copy of This Notice: You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have received this Notice electronically, you are still entitled to a paper copy of this Notice. You may obtain a copy of this Notice at our websites or you can request a copy in writing at: Clinical Management Corporation of America, Clearwater, Florida 33758-9878 or in our offices where services or treatment was rendered: AWHC (city), WOBGYN, FTMWHC or LWHC.

Changes to This Notice
The effective date of this Notice is June 16, 2021. It will remain in effect until we replace it.

AWHC (city), WOBGYN, FTMWHC and LWHC will abide by the terms of the Notice currently in effect. AWHC (city), WOBGYN, FTMWHC and LWHC reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all protected health information that it maintains. Any updated version of this Notice may be obtained in writing at: Clinical Management Corporation of America, PO Box 5271, Clearwater, Florida 33758-9878.

Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with us, contact: Clinical Management Corporation of America, PO Box 5271, Clearwater, Florida 33758-9878. You may also call our Compliance Office at (727) 442-0445 ext. 26. You will not be penalized for filing a complaint.

Other Uses of Medical Information
other uses and disclosures of medical information not covered by this Notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you. If you have any questions about this notice, please contact the office where services or treatment were rendered at: AWHC (city), WOBGYN, FTMWHC or LWHC or please submit questions in writing to: Clinical Management Corporation of America, PO Box 5271, Clearwater, Florida 33758-9878 or (727) 442-0445 ext. 26.

All Women’s Health Center, Inc. (AWHC St Pete)
4131 Central Avenue
St Petersburg, Florida 33713
(727) 327-3300 / Toll Free: (800) 736-6656
floridaabortion.com

All Women’s Health Center of North Tampa, Inc. (AWHC Tampa)
14498 University Cove Place
Tampa, Florida 33613
(813) 978-1919 /Toll Free: (800) 733-7907
floridaabortion.com

All Women’s Health Center of Sarasota, Inc. (AWHC Sarasota)
2700 South Tamiami Trail, Suite 5
Sarasota, Florida 34239
(941) 366-7066 / Toll Free: (800) 347-7066
floridaabortion.com

Lakeland Women’s Health Center, Inc. (LWHC)
4444 South Florida Avenue
Lakeland, Florida 33813
(863) 644-7541 /Toll Free: (800) 733-7541
floridaabortion.com

All Women’s Health Center of Jacksonville, Inc. (AWHC Jacksonville)
1545 Huffingham Road
Jacksonville, Florida 32216
(904) 731-2755 / Toll Free: (800) 733-2755
floridaabortion.com

Women’s Obstetrical & Gynecology Center of Countryside, Inc. (WOBGYN)
28960 US Hwy 19 North, Suite 11 O
Clearwater, Florida 33761
(727) 785-2525 I Toll Free: (800) 827-00821
floridaabortion.com

All Women’s Health Center of Tampa, Inc. (AWHC Tampa)
3330 W Kennedy Blvd
Tampa, Florida 33609
(813) 874-0505 /Toll Free: (800) 736-0505
floridaabortion.com

Ft Myers Women’s Health Center, Inc. (FMWHC)
3677 Central Avenue, Suite H
Ft Myers, Florida 33901
(239) 936-4494 / Toll Free: (800) 733-4494
floridaabortion.com

All Women’s Health Center of Gainesville, Inc. (AWHC Gainesville)
1135 N.W. 23″‘ Avenue, Suite N
Gainesville, Florida 32609
(352) 378-9191 /Toll Free: (800) 869-0440
floridaabortion.com

All Women’s Health Center of Orlando, Inc. (AWHC Orlando)
431 Maitland Avenue
Altamonte Springs, Florida 32701
(407) 834-2262 / Toll Free: (888) 257-2262
floridaabortion.com

Compliance Officer
PO Box 5271
Clearwater, Florida 33765
(727) 442-0445 ext. 26

revised 6/18/2021

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Privacy Statement

Floridaabortion.com has created this privacy statement in order to demonstrate our firm commitment to privacy. The following discloses the information gathering and dissemination practices for this Web site

You have the right to privacy. Our staff will not release information about you, your procedure or even confirm that you are our patient without your consent. We realize this can create some problems when you have asked someone to call on tour behalf.

However, to assure your privacy, we will need to speak only to you about your care, or you can sign a Written Release of information so that we can indeed communicate with your loved one, your physician or someone else of your choosing.

Contact Person: Administrator

St.Pete 727-327-3300
Clearwater 727-785-2525
N.Tampa 813-978-1919
S.Tampa 813-874-0505
Sarasota 941-366-7066
Ft.Myers 239-936-4494
Lakeland 863-644-7541
Gainesville 352-978-9191
Jacksonville 904-731-2755
Orlando 407-834-2262

 

Information Automatically Logged

We use your IP address to help diagnose problems with our server and to administer our Web site. We use the IP address and other generic information (Browser and Operating System Version) to generate statistics for our hosted websites.

Personal Information

All of our web sites do not request any personal information or collect any information that personally identifies you or allows you to be personally contacted, unless otherwise specified by a separate privacy policy.

External Links

This site contains links to other sites. floridaabortion.com is not responsible for the privacy practices or the content of such Web sites.

Security

This site has security measures in place to protect the loss, misuse, and alteration of the information under our control. The only logged information is accessible only to administrators with logins to our internal servers.

Contacting the Web Site

If you have any questions about this privacy statement, the practices of this site, or your dealings with this Web site, you can contact: webmaster@floridaabortion.com

revised 6/18/2021