The following is a summary of our privacy practices which contains a condensed version of our Notice of Privacy Practices. The complete notice is available upon request for your review. 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. We reserve the right to revise this notice. If and when revision occurs, we will post a copy in our offices and/or website and provide you with a copy upon your request.

How will we use or disclose your information? Here are a few examples (for more details, please refer to the full-length Notice of Privacy Practices): for medical care and treatment, to obtain payment for our services, to generate aggregate data, in emergency situations, to avert a serious threat to health or safety, for appointment and patient recall reminders, for quality improvement initiatives and disease management programs.

Completing a Preventive Medical Physical Exam or a Health Risk Assessment (HRA) may qualify you for an employer sponsored incentive if you are eligible under you company’s current policy. Understand that all of your personal health-related information will be kept strictly confidential as outlined in the Notice of Privacy Practices. The only information shared with your employer is the fact that you have completed an assessment and/or other information required to be eligible for this incentive.

If you believe your privacy rights have been violated, you may file a complaint with Pathfinder or with the Secretary of the Department of Health & Human Services. To file a complaint with Pathfinder, contact Linda Torcivia at 847.686.7284 Ext. 101. All complaints must also 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 your records or receive a paper copy of this notice, the right to amend and an accounting of disclosures, the right to request restrictions, the right to request confidential communications, the right to file a complaint.

PathFinder provides convenient access to preventive health care. The scope of this preventive care is limited to the assessment of risks for important preventable chronic diseases, consultation regarding these risks and formulation of a personal prevention plan intended to address some of these risks. Our care does not include diagnosis or management of acute or chronic health concerns. If a risk is identified, you will be referred to your community health system as the scope of our care is not able to include ongoing health services. We recommend the engagement of all participants with a primary medical doctor in their local health system.

Patient Acknowledgment: I hereby acknowledge receipt of this Notice of Privacy Practices and understand the scope of care provided by PathFinder Health. I further acknowledge that I have been given an opportunity to ask questions and that my questions have been answered to my satisfaction in language