HOME SERVICES GIVE VOLUNTEER EVENTS BLOG CONTACT NOTICE OF PRIVACY PRACTICES – SUMMARY YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES. This summary 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. If you have any questions about this notice or matters covered by this notice, please contact our Health Insurance Portability and Accountability Act of 1996 (HIPAA) Compliance Officer at (206) 695-7600 ext. 2409. The information on this page is not a substitute for our complete Notice of Privacy Practices. There are exceptions to the summary statements listed below, which are explained in our actual Notice of Privacy Practices. We urge you to review the actual notice in order to fully understand our responsibilities, our uses and disclosures, your rights and the choices you have in regard to information we have about you. NOTICE OF PRIVACY PRACTICES IN OTHER LANGUAGES Simplified Chinese (繁體中文) | Acknowledgment Traditional Chinese (简体中文) | Acknowledgment Khmer (ភាសាខ្មែរ) | Acknowledgment Korean (한국어) | Acknowledgment Lao (ລາວ) | Acknowledgment Tagalog | Acknowledgment Vietnamese (Tiếng Việt) | Acknowledgment ACRS is designated as a “hybrid entity.” This means that we perform both covered and non-covered functions (under HIPAA). Please review our list of HIPAA covered and non-covered programs for more information. OUR RESPONSIBILITIES: PROTECTING YOUR PRIVACY We must do the following and more: We are required by law to maintain the privacy and security of your protected health information. We will let you know promptly 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 the linked notice and give you a copy of it. We must ask you to sign a document stating you received our notice of privacy practices. You don’t have to sign it and it will not affect your eligibility for ACRS services. We will not use or share your information other than as described on our notice unless you tell us we can in writing. If you tell us we can, you may still change your mind at any time. Let us know in writing if you change your mind. USES AND DISCLOSURES OF INFORMATION We may use or share your information in order to: Provide services to you Run our organization Bill for your services Help with public health and safety issues Comply with the law Address workers’ compensation and other government requests Respond to lawsuits and legal actions YOUR CHOICES You have some choices in the way that we use and share information, which include: Whether family and friends should know about your condition What information can be shared about you in a disaster relief situation Whether we can share your information for marketing purposes If we can use information about you to raise funds YOUR RIGHTS You have the right to: Get a copy of your paper or electronic medical record Correct your paper or electronic medical record Request confidential communication Ask us to limit the information we use or share Get a list of those with whom we’ve shared your information Get a copy of our privacy notice Choose someone to act for you File a complaint if you believe your privacy rights have been violated Disclaimer: This document is not to be provided in place of our actual Notice of Privacy Practices. The statements above are only a summary of some of the matters covered by our Notice of Privacy Practices. There are exceptions to the statements listed above which are explained in our complete Notice of Privacy Practices. We urge you to review the actual notice in order to fully understand our responsibilities, our uses and disclosures, your rights and the choices you have in regard to information we have about you. 3639 Martin Luther King Jr. Way S Seattle, WA 98144 (206) 695-7600 (206) 695-7606 info@acrs.org FOLLOW US ON: About Us Notice of Privacy Practices Methods of Payment Rental Newsroom Careers Blog Stay in Touch! Sign up to receive news and invitations. A Nonprofit Partner of © 2016 ASIAN COUNSELING AND REFERRAL SERVICE. ALL RIGHTS RESERVED.