Georgia Vascular Institute Privacy Notice

The following notice describes how your medical information may be used and disclosed, and how you can get access to this information. Please review this information carefully. We are required by law to maintain the privacy of your health information, to give you this notice, and your rights concerning your health information.

Your Authorization: In addition to our use of your health information for treatment, payment or healthcare operations, you may give written authorization to use your health information or to disclose it to anyone for any purpose.

To Your Family and Friends: We must disclose your health information to you, as described in the patient rights section of this notice. We may disclose your health information to a family member, friend or other person to the extent necessary to help with your healthcare, but only if you agree that we may do so.

The office is required by law to protect the privacy of its patients. It will keep confidential any and all patient healthcare information and will provide patients with a list of duties that protect confidential healthcare information.

Your confidential healthcare information may be released to other healthcare professionals for the purpose of providing you with quality healthcare.

Your healthcare information may be released to your insurance provider for the purpose of the office receiving payment for providing you with needed healthcare services.

Your confidential healthcare information may be released to public or law enforcement officials in the event of an investigation in which you are a victim of abuse, a crime or domestic violence.

Your confidential healthcare information may be released to other healthcare providers in the event you need emergency care.

Your confidential healthcare information may be released to a public health organization or federal organization in the event of a communicable disease or to report a defective or untoward event to a biological product (food or medicine).

Your confidential healthcare information may not be released for any other purpose that which is identified in this notice.

Your confidential healthcare information may be released, for purpose other than the above, only after receiving written authorization from you and you may revoke your permission to release confidential healthcare information at any time.

You may be contacted by the office to remind you of any appointments, healthcare treatment options or other health services that may be of interest to you (via phone or mail).

You have the right to restrict the use of your confidential healthcare information. However, the office may choose to refuse your restrictions if it is in conflict of providing you with quality healthcare or in the event of an emergency situation.

You have the right to receive confidential communication about your health status.

You have the right to review and request photocopies by making request in writing.

You have the right to request in writing that we communicate with you about your health information by alternative means or alternative locations.

You have the right to request an amendment to your information. However, the office can refuse request in writing stating reason for denial.

You have the right to know who has accessed your confidential healthcare information and for what purpose for other than treatment, payment, and healthcare operations.

You have the right to posses a copy of this privacy notice upon request. This copy can be in the form of an electronic transmission or on paper.

The office will abide by the terms of this notice. The office reserves the rights to make changes to this notice and continue to maintain the confidentiality of all healthcare information. Patients will receive a mailed copy of any changes to this notice within 60 days of making the changes.

You have the right to complain to the office if you believe your rights to privacy have been violated. If you feel your privacy rights have been violated, please mail your complaint to:


Georgia Vascular Institute
7130 Mt. Zion Blvd.
Suite 10
Jonesboro, GA 30236