Your Information Your Rights Our Responsibilities
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.
| Effective date September 23, 2026 |
Privacy contact Privacy Officer, Florida Injury Centers (386) 402-4250 Records@floridainjurycenters.com |
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Your rights
You have the right to:
- Get an electronic or paper copy of your medical record.
- Ask us to correct your medical record.
- Request confidential communications.
- Ask us to limit the information we use or share.
- Get a list of certain disclosures of your information.
- Get a copy of this notice.
- Choose someone to act for you.
- File a complaint if you believe your privacy rights have been violated.
Your choices
In certain situations, you may tell us how you want us to use or share your information, including communications with family and others involved in your care. Written authorization is generally required for marketing, the sale of protected health information, and most uses of psychotherapy notes.
Our uses and disclosures
We may use and share your information for treatment, payment, health care operations, and other purposes permitted or required by law. The detailed sections below explain these uses and your rights.
Your rights in detail
Get an electronic or paper copy of your medical record
- You may ask to see or obtain an electronic or paper copy of your medical record and other health information we maintain about you. Contact us to learn how to submit the request.
- We will provide a copy or summary as required by law, generally within 30 days. We may charge a reasonable, cost-based fee permitted by law.
Ask us to correct your medical record
- You may ask us to amend health information that you believe is incorrect or incomplete. Your request must be in writing and explain why the information should be changed.
- We may deny the request in circumstances permitted by law, but we will explain the denial in writing, generally within 60 days.
Request confidential communications
- You may ask us to contact you in a specific way, such as by cell phone instead of home phone, or to send mail to a different address.
- We will accommodate reasonable requests. Your request should tell us how or where you want to be contacted.
Ask us to limit what we use or share
- You may ask us not to use or share certain information for treatment, payment, or health care operations. We are generally not required to agree, and we may deny a request if it could affect your care. If we agree, we may still share the information when emergency treatment requires it.
- If you pay in full out of pocket for a service or item, you may ask us not to disclose that information to your health plan for payment or health care operations. We will agree unless a law requires disclosure.
Get a list of certain disclosures
- You may request an accounting of certain disclosures made during the six years before your request, including who received the information and why.
- The accounting generally will not include disclosures for treatment, payment, or health care operations; disclosures made to you; disclosures you authorized; or other disclosures excluded by law.
- We will provide one accounting in a 12-month period without charge. A reasonable, cost-based fee may apply to additional requests during that period.
Get a copy of this notice
You may ask for a paper copy at any time, even if you agreed to receive it electronically. We will provide a copy promptly.
Choose someone to act for you
- If a personal representative, legal guardian, or person holding medical power of attorney has legal authority to act for you, that person may exercise your rights and make choices about your information.
- We will verify the person’s authority before taking action.
File a complaint if you believe your rights were violated
- You may complain to FIC by contacting our Privacy Officer using the information at the end of this notice.
- You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by writing to 200 Independence Avenue SW, Washington, DC 20201; calling 1-877-696-6775; or visiting https://www.hhs.gov/hipaa/filing-a-complaint/.
- We will not retaliate against you for filing a complaint.
Your choices about sharing
For certain health information, you may tell us your preferences. If you have a clear preference, tell us what you want us to do.
Family members and others involved in your care
- You may tell us to share information with family members, close friends, or others involved in your care or payment for your care.
- You may tell us how to share information in a disaster-relief situation.
- If you cannot tell us your preference, such as when you are unconscious, we may share information if we believe it is in your best interest. We may also share information when needed to lessen a serious and imminent threat to health or safety.
Uses requiring written authorization
Except when otherwise permitted by law, we will not use or disclose your information for the following without your written authorization:
- Marketing purposes.
- Sale of your protected health information.
- Most uses and disclosures of psychotherapy notes.
FIC does not use protected health information for fundraising. If this practice changes, you will have the right to opt out as required by law.
How we typically use or share your information
Treat you. We may use your information and share it with physicians, therapists, imaging facilities, pharmacies, specialists, and other professionals involved in your treatment or care coordination. For example, we may send a physician’s order and relevant clinical information to an imaging center or specialist.
Run our organization. We may use and share information to operate our practice, improve quality, train staff, review services, coordinate care, communicate with you, and manage business functions. Business associates that support these activities must protect your information as required by contract and law.
Bill for services. We may use and share information with health plans, insurers, attorneys or other authorized payers, billing vendors, and others involved in payment or benefits administration.
Other permitted or required uses and disclosures
We may use or disclose information in other ways permitted or required by law. These disclosures are subject to applicable conditions and, when required, the minimum-necessary standard.
Public health and safety
- Prevent or control disease.
- Assist with product recalls.
- Report adverse reactions to medications.
- Report suspected abuse, neglect, or domestic violence.
- Prevent or reduce a serious threat to health or safety.
Research
- Use or disclose information for approved health research when the requirements of law are met.
Compliance with law
- Disclose information when state or federal law requires it, including to the U.S. Department of Health and Human Services to demonstrate compliance with federal privacy law.
Organ and tissue donation
- Share information with organ-procurement organizations when applicable.
Medical examiners and funeral directors
- Share information with a coroner, medical examiner, or funeral director when an individual dies and the disclosure is permitted by law.
Workers’ compensation, law enforcement, oversight, and government functions
- Use or disclose information for workers’ compensation claims; lawful law-enforcement purposes; authorized health-oversight activities; and special government functions such as military or national-security activities.
Lawsuits and legal proceedings
- Disclose information in response to a court or administrative order, subpoena, discovery request, or other lawful process when the requirements of HIPAA and other applicable law are satisfied.
Substance use disorder records
To the extent we receive or maintain substance use disorder patient records protected by 42 CFR Part 2:
- We will not use or disclose those records in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a court order accompanied by a subpoena, as required by applicable law.
- We will provide any additional notice and choice required before using Part 2 information for fundraising. FIC does not currently use protected health information for fundraising.
Our responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will notify you as required by law if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and provide you with a copy.
- We will not use or share information other than as described here unless you authorize us in writing. You may revoke an authorization in writing at any time, but revocation will not undo actions already taken in reliance on the authorization.
Florida confidentiality protections
Some Florida and federal laws may provide additional protections for certain information, including mental health, substance use disorder, HIV-related, genetic, minor, and other specially protected records. When a law is more protective than HIPAA, FIC will follow the more protective requirement that applies to the information and the requested use or disclosure.
Changes to this notice
We may change the terms of this notice. A revised notice may apply to all information we maintain, including information created or received before the revision. The current notice will be available upon request and posted on our website.
Contact the Privacy Officer
| Privacy Officer Florida Injury Centers 125 E. Merritt Island Causeway, Suite 107 #406 Merritt Island, Florida 32952 Office: (386) 402-4250 Main: (866) 402-4250 Email: Records@floridainjurycenters.com Website: www.floridainjurycenters.com |
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This notice applies to Florida Injury Centers and the physicians, workforce members, and authorized service providers participating in its health care operations. It does not create rights beyond those provided by applicable law.