Statement of Patient Rights
New Directions Counseling Corp
1200 Airport Heights Drive Suite 170
Anchorage, AK 99508
Phone (907) 929-5258
Client Rights
Right to request how we contact you.
It is our normal practice to communicate with you at your home address and daytime phone number about health matters, such as appointment reminders etc. Sometimes we may leave a message on your voicemail. You have the right to request that our office communicate with you in a different way other than the method that was given to us when you scheduled your appointment
Your right to release your medical records.
You may consent in writing to release your records to others. You have the right to revoke this authorization, in writing, at any time. However, a revocation is not valid to the extent that we acted in reliance on such authorization
Your right to inspect and copy your medical and billing records.
You have the right to inspect and obtain a copy of your information contained in my medical records. To request access to your billing or health information, contact New Directions Counseling Corp. Under limited circumstance we will release that information to you within a 72 hour period, or we may deny your request to inspect and copy. If you ask for a copy of any information, we may charge a reasonable fee for the costs of copying, mailing and supplies.
Your right to add information or amend your medical records.
If you feel that information contained in your medical record is incorrect or incomplete, you may ask New Directions Counseling Corp to add information to amend the record. To request an amendment, you must contact New Directions Counseling Corp during normal business hours Monday thru Friday. We will then require you to submit your request in writing and to provide an explanation concerning the reason for your request within 48 hours. We will then make a decision on your request with 60 calendar days, or some cases within 90 calendar days. Under certain circumstance, we may deny your request to add or amend information. If we deny your request, you have a right to file a statement that you disagree. Your statement and our response will be added to your record.
Your right to an accounting of disclosures.
You may request an accounting of any disclosures, if any, that we have made related to your medical information, except for information that we used for treatment, payment, or health care operational purposes or that we shared with you or your family, or information that you gave us specific consent to release. It also excludes information that we were required to release. To receive information regarding disclosure made for specific time periods no longer than six years and after April 14, 2003, please submit your request in writing to us. We will notify you of the cost involved in preparing this list within 72 hours.
Your right to request restrictions on uses and disclosures of your health information.
You have the right to ask for restrictions on certain uses and disclosures of your health information. This request must be in writing and submitted to us. However, we not required to agree to such a request.
Your right to complain.
If you believe your privacy rights have been violated, please contact us personally, and discuss your concerns. If you are not satisfied with the outcome, you may file a written complaint with the U.S. Department of Health and Human Services. An individual will not be retaliated against for filing such a complaint.
Your right to receive changes in policy.
You have the right to receive any future policy changes secondary to changes in state and federal laws. This can be obtained from us, New Directions Counseling Corp.
Effective date: April 14, 2003