Health Insurance Portability and Accountability Act (HIPAA)
Notice Effective Date: April 15, 2008
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
Questions about this notice should be directed to Christopher Lutz, Sports Performance and Resistance Training Association, email@example.com
Our Pledge Regarding Your Medical Information
S.P.A.R.T.A. is dedicated to protecting your personal medical information. When you receive personal fitness training with a S.P.A.R.T.A. trainer we create a record set necessary for:
- your fitness training,
- our payment actions related to your fitness training, and
- management of our operations related to your fitness training.
Health records may be created by S.P.A.R.T.A. personnel. Non-employee doctors, physical therapists and other licensed professionals may have different policies or notices regarding use and disclosure of your medical information created in their private offices or clinics. They are responsible to provide you with their Notice of Privacy Practices.
Required by Law
This notice applies to how we may use and disclose your medical records while you are receiving training at S.P.A.R.T.A.. It also describes your rights with respect to your personal medical information. We are required by law to:
- make sure that medical information that identifies you is kept private;
- give you this notice that describes why and how we may use or share your medical information
- have you sign a form signifying you received a copy of the notice; and
- follow the terms of this notice on its effective date and thereafter until modified.
There may be circumstances when state law supersedes HIPAA, for example HIV, Drug and Alcohol, and Mental Health information. In these situations, we will follow the provisions of the specific state law.
How We May Use and Disclose Medical Information About You
The following categories describe different ways we use and disclose medical information. For each category of uses or disclosures we explain what we mean and give some examples. All of the ways we use and disclose information will fall within one of the categories.
- For Fitness Training
- For Payment
- For Training Operations
- Appointment Reminders
- Fitness Training Alternatives: We may use and disclose medical information to tell you about or recommend possible fitness training options or alternatives that may be of interest to you.
- Health-Related Benefits and Services: We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.
- Individuals Involved in Your Training or Payment for Your Training
- As Required By Law
- To Avert a Serious Threat to Health or Safety: We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
Your Rights Regarding Medical Information About You
You have the following rights regarding medical information we maintain about you:
- Right to Inspect and Copy: You have the right to inspect and copy your medical information that may be used to make decisions about your training.
- Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for S.P.A.R.T.A..
We may deny your request if you ask us to amend information that:
- Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
- Is not part of the information kept by or for S.P.A.R.T.A.;
- Is not part of the information which you would be permitted to inspect and copy; or
- Is accurate and complete.
- Right to an Accounting of Medical Information Disclosures: We keep a record of every time we share your medical information for purposes other than fitness training, payment and operations. We generally classify these types of disclosures as "non-routine" and we control and track such disclosures. We do not maintain a record of disclosures made when you have given written authorization for such disclosures.
- Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for fitness training, payment or operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about your fitness training at S.P.A.R.T.A. to your family members. To request restrictions, you must make your request in writing to S.P.A.R.T.A..
In your request, you must tell us:
- what information you want to limit;
- whether you want to limit our use, disclosure or both; and
- to whom you want the limits to apply, for example, disclosures to your family.
We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide emergency services to you.
- Right to Request Confidential Communications: You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing. Your request must specify how or where you wish to be contacted. You do not have to provide the reason for your request. S.P.A.R.T.A. will accommodate all reasonable requests.
- Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. To obtain another paper copy of this notice, contact the Center Privacy Officer or Corporate Privacy Officer. You may obtain an electronic copy of this notice at our website, www.spartatraining.com. Even if you have an electronic version of the Notice, you are still entitled to a paper copy if you want one.
Changes to This Notice
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any medical information we create in the future. We will post a copy of the current notice at appropriate client access points in our fitness training facilities. The notice will contain its effective date on the top of the first page. In addition, each time you register at or are admitted to S.P.A.R.T.A. for fitness training or health care services as an inpatient or outpatient, we will ask you if you want a copy of the current notice in effect.
If you believe your privacy rights have been violated, you may file a complaint with S.P.A.R.T.A..
To file a complaint with S.P.A.R.T.A., all correspondence should go to:
P.O. Box 1384
Leesburg, VA 20177
All complaints must be submitted in writing. Your complaint actions will be held in the strictest confidence. S.P.A.R.T.A. will not take any actions to discourage you from filing a complaint nor will we act against you in any way because of filing a complaint.