Your Health Information Rights

You have the following rights:

• You may request a restriction on certain uses and disclosures of your information as provided by 45CFR§164.522. However, Mourning Dove Home Care LLC is not required to agree to a requested restriction unless it is a request to restrict disclosure of your protected health information to your health plan and if the disclosure is for the purpose of carrying out payment or healthcare operations and is not otherwise required by law; and if the protected health information pertains solely to a healthcare item or service for which you have paid in full.

• You have the right to see copies of your electronic health record if Mourning Dove Home Care LLC uses electronic health records.

• You have the right to request and obtain a paper copy of the notice of information practices upon request.

• You have the right to obtain and/or inspect a copy of your health record as provided for in 45CFR§164.524.

• You have the right to amend your health record as provided in 45CFR§164.526.

• You have the right to request communications of your health information by alternative means or at alternative locations.

• You have the right to revoke your authorization to use or disclose health information except when i) action has already been taken or ii) if the authorization was obtained as a condition of obtaining insurance coverage or other laws that could provide the insurer with the right to contest a claim under their policy.

• You have the right to receive an accounting of where your protected health information was disclosed during the six years prior to the date of your request.