Patient Privacy Policy


We understand that health information about you and the care you receive is persona.  We are committed to protecting your personal health information.  When you receive treatment and other health care service from us, we create a record of the services that received.  We need this record to provide with quality care and to comply with legal requirements. This notice applies to all of our records about your care, whether made by our health care professionals or others working in this office, and it tells you about the ways in which we may use and disclose your person health information.  This notice also describes your rights with respect to the health information that we have kept about you and the obligations that we have when we use and disclose your health information.
We are required by federal law to:

1. Make sure that health information identifies you is kept private in accordance with relevant law
2. Give you this notice of our legal duties and privacy practices with respect to your personal health information
3. Follow the terms of the notice that currently in effect for all of your personal health information


If you think that we may have violated our privacy rights or you disagree with a decision we made about access to your personal health information, you may file a complaint with person listed below.  You also may send a written complain to the Regional Manager, Office of Civil Rights, U.S. Department of Health and Human Services, 200. Independence Avenue, Washington, D.C. 20201 in writing within 180 days of violation of rights.  We will take no retaliatory action against you if you file a complaint against our privacy practices.


If you have any questions about this Notice or any complains about our privacy or practices, or would like to know how to file a complain with the Secretary of the Department of Health and Human Services – Please contact:

Eastern Shore Pediatrics LLC
211 Maryland Avenue
Salisbury, MD 21801
(410) 219-9111




We may use and disclose your person health information for these purpose:

For treatment:  We may use and disclose health information about you to doctors, nurses, technicians, medical students, and others who are involved in your care.

For payment: We may use and disclose health information about you to bill and collect payment for the treatment and services provided to you.  WE may also provide this information to your health insurance plan to process claims or get pre-approval for coverage of treatment.

For health care operations:  we may use and disclose health information about you to operate this clinic, to assist other providers involved in your care, to ensure quality care, and to evaluate the perform ace of our staff in caring for you

Appointment reminders & health-related services:  We may use and disclose health information about you to provide appointment reminders.

Disclosures to family, friends or others:  We may release health information about you to a friend or family member who is involved in your health care or to the person who helps pay for your care. We have chosen to participate in the Chesapeake Regional Information System for our patients (CRISP); a regional health information exchange serving Maryland and D.C.As permitted by law, your health information will be shared with this exchange in order to provide faster, access, better coordination of care and assist providers and public health officials in making more informed decisions. You may ‘opt-out” and disable access to your health information available to CRISP by calling 1-877-952-7477 or completing and submitting an Opt-Out form to CRISP by mail, fax or through their website at Public health reporting and controlled Dangerous Substance information, as part of the Maryland Drug Monitoring Program (PDMP), will still be available to providers.

Research: Under certain circumstance, we may use and disclose health information about you for research purposes, which would be subject to a special approval.

As required by law: We will disclose health records u when required  by federal, state or local law.

To avert a serious threat to health or safety:  We may use and disclose health information about you if necessary to prevent serious threat to your health and safety, or the health and safety of the public or another s another person.  Any disclosure, however, would only be to someone able to help prevent the treat.

Public Health Activities:  We may release health information about you to prevent or control disease, injury or disability and to report: births and deaths, child abuse or neglect, medication reactions or problems. Product recalls, and to notify of exposure to disease.  We also may notify the appropriate authority if we believe a patient has been the victim of abuse, neglect or domestic violence when required by law.

Health Oversight Activities:  We may provide information to assist the government when conducting an investigation or inspection of a health care provider or organization.

Lawsuits and Disputes:  We may use and disclose health information about you in response to a court or administrative order, a subpoena, discovery request, or other lawful process, but only if efforts have been made to tell you about the request or obtain an order protecting the information requested.

Law enforcement:  We may release health information about you if asked to do so by law enforcement official in response to a court order, subpoena, warrant, or summons; or to identify or locate a suspect, fugitive, material witness or missing person; or under certain circumstance, about the victim of a crime or criminal conduct at the clinic.

For specific government functions:  We may use and disclose health information about you to authorized federal officials for intelligence and other legal national security activities; or provide protection to the President of foreign heads of state.  We may also release health information about you to coroner or health examiner.

Inmates:  Only if a release of health information would be necessary for the institution to provide health care, to protect your health and safety, or for the safety and security of the correctional institution.

Other:  Other uses and disclosures of your personal health information would require your prior written authorization.  Yo can revoke this written authorization at any time in writing.
Psychotherapy notes: An authorization is required for uses and disclosures of psychotherapy notes.


Right to inspect & copy: You can inspect and copy your personal health information in your records,
Upon a written request.  In certain very limited circumstances, your request may be denied; you can then request that the denial be reviewed.  We will comply with the outcome of the review.

Right to amend:  if you feel information maintained about you is incorrect or incomplete, you can request an amendment to your record in writing, and it must contain a reason to support your request for an amendment.  We may deny your request if it is not in writing or legible or if it: was not created by us, is not part of the health information kept y or for the health center, is not part of the information which you would be permitted to inspect and copy, or if the information is accurate and complete.

Right to receive an accounting of disclosures:  Any accounting will not include uses or disclosures that you have already consented to, such as those made for treatment or with a written authorization, those that went to a family member/friend involved in your care when you gave us permission to, or to law enforcement officials.  The request needs to be in writing.

Right to request restrictions:  You have the right to ask that we limit how we use and disclose your information, except disclosures we are legally required to make.  You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member.  We are not required to agree to your request if it is not feasible for us to comply or if we believe that it will negatively impact our ability to care for you.  If we agree, however, will comply with your request except in emergency situations.  Requests must be in writing.

Right to receive confidential communications:  You can request in writing that we communicate with you about health matters in a certain way.  For example, you can ask that we contact you at work only, or by mail to a specified address.  We will accommodate all reasonable request and we will not ask you the reason for request.

Right to a paper copy of this Notice:  You have the right to receive a copy of this Notice at any time.  Please request it from our Staff.