Office Policies
  1. Office Procedures and Policy Statement
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  2. We have the right and are required by law to disclose limited information to protect any other individual should we believe that you have threatened (or implied a threat of) bodily harm to another with intent to act upon those threats. 

  3. We have the right and are required by law to disclose limited information to protect any minor (or adult whom is unable to care for him or herself) in the case where we believe there is abuse occurring, regardless of how you are involved.  

  4. We have the right to disagree with any request to alter your record or information if your request would violate our ethical or moral obligations to be truthful, or if the record is reasonably accurate and complete.


    If you have questions, would like additional information, or want to report a problem regarding the handling of your information, you may contact the Office Manager at (615) 269-0525.   Additionally, if you believe your privacy rights have been violated, you may file a written complaint to our office by delivering the written complaint to the Office Manager. You may also file a complaint by mailing it to the Secretary of Health and Human Services whose street address is Atlanta Federal Center, Suite 3B70, 61 Forsythe Street, SW, Atlanta GA 30303-8909 phone (404) 562-7886 fax (404) 562-7881.

  7. We cannot, and will not, require you to waive the right to file a complaint with the Secretary of Health and Human Services (HHS) as a condition of receiving treatment from the office.

  8. We cannot, and will not, retaliate against you for filing a complaint with the Secretary of Health and Human Services.


    PATIENT CONTACT - We may contact you to provide you with appointment reminders, with test or procedure results, with information about treatment alternatives, or with information about other health-related benefits and services that may be of interest to you.

  11. NOTIFICATION – YOU HAVE THE OPPORTUNITY TO AGREE OR OBJECT - Unless you object, we may use or disclose your protected health information to notify, or assist in notifying, a family member, personal representative, or other person responsible for your care, about your location and about your general condition or your death.
    COMMUNICATION WITH FAMILY - Using our best judgment, we may disclose to a family member, other relative, close personal friend, or any other persona you identify, health information relevant to that person’s involvement in your care or in payment for such care if you do not object or in an emergency.
    DISASTER RELIEF EFFORTS - We may use and disclose your protected health information to assist in disaster relief efforts.


    CONTROLLING DISEASES – As required by law, we may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
    CHILD ABUSE & NEGLECT – We may disclose protected health info to public authorities as allowed by law to report child abuse or neglect.
    FOOD AND DRUG ADMINISTRATION (FDA) – We may disclose to the FDA your protected health information relating to adverse events with respect to food, supplements, products and product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacements.
    VICTIMS OF ABUSE, NEGLECT, OR DOMESTIC VIOLENCE -We can disclose protected health information to government authorities to the extent the disclosure is authorized by statute or regulation and in the exercise of professional judgment the doctor believes the disclosure is necessary to prevent serious harm to the individual or other potential victim.
    OVERSIGHT AGENCIES - Federal law allows us to release your protected health information to appropriate health oversight agencies or for health oversight activities to include audits, civil, administrative or criminal investigations, inspections, licensures or disciplinary actions, and for similar reasons related to the administration of healthcare.
    JUDICIAL/ADMINISTRATIVE PROCEEDINGS - We may disclose your protected health information in the course of any judicial or administrative proceeding as allowed or required by law, with your consent, or as directed by a proper court order or administrative tribunal, provided that only the protected health information released is expressly authorized by such order, or in response to a subpoena, discovery request or lawful process.
    LAW ENFORCMENT - We may disclose your protected health information for law enforcement purposes as required by law, such as when required by court order, including laws that require reporting certain types of wounds or other physical injury.
    CORONERS, MEDICAL EXAMINERS AND FUNERAL DIRECTORS - We may disclose your protected health information to funeral directors or coroners consistent with law to allow them to carry out their duties.
    ORGAN PROCUREMENT ORGANIZATIONS - Consistent with applicable law, we may disclose your protected health information to organ procurement organizations or other entities engaged in procurement, banking, or transplantation of organs, eyes, or tissue for the purpose of donation and transplant.
    RESEARCH - We may disclose information to researchers when an institutional review board that has reviewed the research proposal and established protocols to ensure privacy of your protected health information has approved their research.
    THREAT TO HEALTH AND SAFETY - To avert a serious threat to health or safety, we may disclose your protected health information consistent with applicable law to prevent or lessen a serious, imminent threat to the health or safety of a person or the public.
    FOR SPECIALIZED GOVERNMENTAL FUNCTIONS - We may disclose your protected health information for specialized government functions as authorized by law such as to Armed Forces personnel, for national security purposes, or to public assistance program personnel.
    CORRECTIONAL INSTITUTIONS - If you are an inmate of a correctional institution, we may disclose to the institution of its agents the protected health information necessary for your health and the health and safety of other individuals.
    WORKER’S COMPENSATION - If you are seeking compensation through Worker’s Compensation, we may disclose your protected health information to the extent necessary to comply with laws relating to Worker’s Compensation.
    OTHER USES AND DISCLOSURES - Other uses and disclosures besides those identified in this Notice will be made only as otherwise authorized by law or with your written authorization which you may revoke except to the extent information or action has already been taken.

  14. WEBSITE - If we maintain a website that provides information about our entity, this Notice will be on the website.   

Human beings, who are almost unique in having the ability to learn

from the experience of others, are also remarkable for their apparent

     disinclination to do so. -- Douglas Adams