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NOTICE OF PRIVACY PRACTICES Dear OIL CENTER SURGICAL PLAZA Patient: It is the policy of OIL CENTER SURGICAL PLAZA (Facility) to maintain patient privacy and comply with governmental regulations related
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How to fill out notice of privacy practices

01
Read the notice of privacy practices provided by your healthcare provider.
02
Fill out any required information such as your name, date, and signature.
03
Make sure all sections are completed accurately and legibly.
04
Ask any questions or seek clarification on any terms or sections you do not understand.
05
Return the completed notice of privacy practices as instructed by your healthcare provider.

Who needs notice of privacy practices?

01
Anyone who receives healthcare services or treatment from a healthcare provider.
02
Patients or individuals who provide personal information to a healthcare provider.
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The notice of privacy practices is a document that explains how personal health information may be used and disclosed.
Healthcare providers, health plans, and healthcare clearinghouses are required to file notice of privacy practices.
The notice of privacy practices can be filled out by providing information on how personal health information is used, disclosed, and protected.
The purpose of the notice of privacy practices is to inform individuals about their privacy rights and how their health information is handled.
The notice of privacy practices must include information on how personal health information is used, disclosed, and protected.
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