NOTICE OF PRIVACY

OB/GYN of Fairfield County, LLC

Primary Address:

1735 Post Road Fairfield, CT 06824

Effective: March 1, 2004

This practice is committed to protecting the privacy and confidentiality of your protected health information. This Notice describes your rights and certain obligations we have regarding our privacy practices and the use and disclosure of your protected health information. "Protected health information" is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.

This Notice describes the privacy practices of OB/GYN of Fairfield County, LLC.  This entity, all sites and locations of this entity, follow the terms of this Notice.  In addition, this entity, sites and locations may share protected health information with each other for treatment, payment or health care operation purposes described herein.

This practice is required by law to protect the privacy of your protected health information and to provide you with and to abide by the terms of this Notice as it may be updated from time to time.  If you have any questions about this Notice, please call the contact listed above.

The following categories describe different ways that we use and disclose protected health information.  While not every use or disclosure in a category will be listed, all of the ways we are permitted to use and disclose information will fall within one of the categories.

The law permits us to use and disclose your protected health information for purposes of healthcare treatment, payment and healthcare operations as described below.

Ø                  Treatment  We may use protected health information about you to provide you with medical treatment or services and to coordinate and manage your care and any related services.  Protected health information about you may be disclosed to hospitals, nursing facilities, doctors, nurses, technicians, medical students and other personnel who are involved in your care. We may disclose information to people outside our practice who may be involved in your care, such as designated family members. We may also disclose your protected health information to providers or facilities that may be involved in your care after you leave our office or our care. This would include, for example, when your physician consults with a specialist or your primary care physician, regarding your condition or coordinates services you may need, such as lab work and x-rays.

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