11083 Village Square LN

Fishers, IN   46038


​info@hope-pt.com












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Military and Veterans. If you are a member of the armed forces, we may release Health Information as required  by military command authority if you are a member of a foreign military.


Workers' Compensation. We may release Health Information for workers' compensation or similar  programs. These programs provide benefits for work-related injuries or illness.


Public Health Risks.  We may disclose Health Information for public health activities. These activities generally include disclosures to prevent or control disease, injury or disability; report births and deaths; report child abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; a person who may have been exposed to a disease  or condition; and the appropriate government authority if we believe a patient has been a victim of abuse, neglect or domestic violence. We will only make disclosure if you agree or when required or authorized by law.


Health Oversight Activities. We may disclose Health Information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, and licensure. These activities are necessary for the government  to monitor the health care system, government programs, and compliance with civil rights law.


Data Breach Notification Purposes. We may use or disclose your Protected Health Information to provide legally required notice of unauthorized access to or disclosure of your health information. 


Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose Health Information in response to a court or administrative order. We also may disclose Health Information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain and order protecting the information requested.


Law Enforcement. We may release Health Information if asked by a law enforcement official if the information is: (1) in response to a court order, subpoena, warrant, summons or similar process; (2) limited information to identify or locate a suspect, fugitive, material witness, or missing person; (3) about the victim of a crime even if, under certain very limited circumstances, we are unable to obtain person's agreement; (4) about a death we believe may be the result of criminal conduct; (5) about criminal conduct on our premises; and (6) in an emergency to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.


Inmates or Individuals in Custody. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release Health Information to the correctional institution or law enforcement  official. This release would be if necessary; (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; (3) the safety and security of the correctional institution.


USES AND DISCLOSURES THAT REQUIRE US TO GIVE YOU AN OPPORTUNITY TO OBJECT AND OPT


Individuals Involved in Your Care or Payment for Your Care. Unless you object, we may disclose to a member of your family, a relative, a close friend, or any other persons you identify, your Protected Health Information that directly relates to that person's involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary of we determine that it is in your best interest based on our professional judgment.


Disaster Relief. We may disclose your Protected Health Information to disaster relief organizations that seek your Protected Health Information to coordinate your care, or notify family and friends of your location or condition is a disaster. We will provide you with an opportunity to agree or object to such a disclosure whenever we practically can do so.


YOUR WRITTEN AUTHORIZATION IS REQUIRED FOR OTHER USES AND DISCLOSURES

The following uses and disclosures of your protect health Information will be made only with your written authorization.


1. Uses and disclosures of Protected Health Information for marketing purposes; and (2) disclosures that constitute a sale of your Protected Health Information


Other uses and disclosures of Protected Health Information not covered by this notice or the laws that apply to us will be made only with your written authorization. If you do give us authorization, you may revoke it at any time by submitting a written revocation to our Privacy Officer and we will no longer disclose Protected Health Information under the authorization. But Disclosure that we made in reliance on your authorization before you revoked it will not be affected by the revocation.