Notice of Privacy Practices | Anchor Primary Care
THIS NOTICE OF PRIVACY PRACTICES (“NOTICE”), EFEECTIVE August 1st 2026, DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
OUR RESPONSIBILITY
Anchor Primary Care (“Practice” or “We” or “Us”) is committed to protecting the privacy of your medical information. Your care/treatment is recorded in a medical record that is considered protected health information (“PHI”).
Privacy Obligations
We are required by law to maintain the privacy and security of our protected health information (“PHI”).
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your PHI in ways, other than as described here unless you tell us we can. If you tell us we can, you may change your mind at any time.
Uses and Disclosures
We typically share and use your PHI for your treatment which involves sharing it in Our offices and with the professionals who are treating you.
We also use your PHI for running Our Practice; billing for Our service and getting payment from health plans and other entities; improving your care; and to contact you.
We will also share your PHI if Colorado or federal law requires it, including with the Department of Health and Human Services if it wants to see Our compliance with federal privacy laws.
We will also share your PHI to address workers’ compensation, law enforcement, health oversight agencies, and special government functions such as military, national security, and presidential protective services.
We will also share your PHI in response to a court or administrative order, or in response to a subpoena.
We will never share your information for marketing or sales purposes unless you provide us with written permission to do so.
In all cases, including those listed within this document, if We have substance use disorder patient records about you, subject to 42 CFR part 2, We cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a court order after notice and an opportunity to be heard is provided to you and a subpoena or other legal requirement compelling disclosure is issued before the record is used or disclosed.
If We have psychotherapy notes or behavioral health records, We cannot use or share information in those records without your specific consent or a court order.
Any other use or disclosure not described in this Notice will be made only with your authorization.
Any time you provide us with a written authorization, you may revoke it any time in writing, to the extent that We have not already acted in reliance on your previous authorization.
You may revoke an authorization in writing at any time by contacting the Director of Operations named below at the phone number or email listed below.
Information disclosed under the terms of this Notice may be subject to redisclosure by the Recipient and may no longer be protected by the HIPAA Privacy Rule, unless another law applies.
Your Rights.
When it comes to your medical record, you have certain rights.
You can ask to see or get an electronic or paper copy of your medical record, by filling out a Medical Record Authorization form and submitting it to Practice. We will provide a copy of your medical record within the number of days permitted under state law.
You can ask us to correct health information that you think is incorrect or incomplete. Your provider will decide whether the requested change inappropriate, and we will let you know when within 60 days if the change has been made.
You can opt-out of sharing your medical records with the statewide Health Information Exchange.
You can ask us to contact you in a specific way (for example, at home, office or cell phone) or to send mail to a different address.
You can ask us not to use or share certain information for treatment, payment, or for our operations. Our office will be unable to honor your request if your medical provider determines it would negatively affect your care. Our office will honor this request unless a law requires us to share the information. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purposes of payment or our operations with your health insurer.
You can ask for a list of the times we have shared your health information, who we have shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations.
You can ask for a paper copy of this notice at any time.
You can ask us to communicate with you by email or standard SMS messaging
You can ask us to share your PHI with others. If you have given someone medical power of attorney, or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
You have the right and choice to tell us to share information and how We should do this with your family, close friend or other person involved in your care, or share information in a disaster relief situation. Tell us what you want us to do, and we will follow your instructions.
If you are not able to tell us your preference (for example, if you are unconscious) we may share information if we believe it is in your best interest. We may also share information when needed to lessen a serious or imminent threat to your health or safety.
Questions; Concerns or Complaints:
If you have any question about this notice or you wish to ask to ask us how to exercise your rights, or you feel your right to privacy has not been respected, you may contact 469-293-3336 or by sending an email to anchordpc@gmail.com. You may also file an official complaint with the US Department of Health and Human Service Office for Civil Rights by sending a letter to 200 Independent Avenue S.W., Washington, D.C.20201; or by visiting https://www.hhs.gov/ocr/privacy/hipaa/complaint.html or by calling 1-877-696-8775. You will not be retaliated against for filing a complaint.
My signature below acknowledges that I have been provided with this Notice of Privacy Practices.
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Patient/Legal Guardian Signature
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Name of Patient/Legal Guardian