NOTICE OF PRIVACY PRACTICES

The notice of privacy practice describes how we may use and disclose your protected health information to carry out treatment, payment or healthcare operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health condition and related healthcare services.

We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of this notice at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, you can receive any revised Notice of Privacy Practices by accessing our website or contacting our Privacy Officer.

The following are examples of how we may use and disclose your protected health information:

Treatment:

• Information obtained by any medical professional, or another member of our health team will be recorded in your medical record and used to help decide what care may be right for you.

• We may also disclose information about you to individuals who may be involved in your medical care, such as family members or others we use to provide services that are part of your care. When required, we will obtain your authorization before disclosing any of your information. Only the minimal amount of information will be revealed during any disclosures.

Payment:

• Your protected health information will be used, as needed, to obtain payment of your healthcare services. Information provided may include your diagnosis, procedure performed, or recommended care.

Healthcare Operations:

• Evaluate the performance of our staff

• Assess the quality of care and outcomes in your case and similar cases

• Learn how to improve our facilities and services

• Determine how to continually improve the quality and effectiveness of the healthcare we provide.

Other Disclosures and Uses of Protected Health Information:

Notification of Family and Others:

• Unless you object, we may release health information about you to a friend or a family member who is involved in your medical acre. We may also give information to someone who helps pay for your care. You have the right to object to this use or disclosure of your information. If you object, we will not use or disclose your information.

We may use and disclose your personal protected information without your authorization under the following circumstances:

Required by Law: We may use or disclose your information to the extent that the use or disclosure is required by law.

Research: We may disclose your information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your information.

Funeral Directors, Coroners and Organ Donation: WE may disclose information for identification purposes, determining the cause of death or for the coroner or medical examiner to perform other duties authorized by law.

Food and Drug Administration (FDA): We may disclose your information to the FDA to report adverse events, product defects, biologic deviations and track products.

Workers Compensation: we may disclose your information as authorized to comply with worker’s compensation laws.

Public Health and Safety Purposes as Allows or Required by Law: We may release your information to prevent or reduce a serious, immediate threat to the health or safety of a person.

To Report Suspected Abuse or Neglect: We may release your information to a public health authority who is authorized by law to receive reports of child abuse or neglect.

Correctional Institutions: We may release your information if you are in a correctional institution, as necessary, for your health and the health and safety of others.

Law Enforcement and Legal Proceedings: We may release your information when we receive a subpoena, court order, other legal process or you are a victim of a crime.

Health and Safety Oversight Activities: We may disclose information to a health oversight agency for activities authorized by law, such as audits, investigations and inspections.

Communicable Diseases: We may disclose your information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

Criminal Activity: We may release your medical information if we believe that the use or disclosure is necessary to prevent or lesson a serious and imminent threat to the health or safety of a person or the public.

Military Activity and National Security: We may release information of armed forces personnel for activities deemed necessary by appropriate military command authorities, for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits or to foreign military authority if you are a member of that foreign military service.

Required Uses and Disclosures: Under the law, we must make disclosures to you, and when required by the Secretary of Heath and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et.seq., Privacy of Individually Identifiable Health Information.

Your Health Information Rights

The health and billing records we create and store are the property of Skill Builders for Kids. However, the protected health information in it belongs to you. You have a right to:

• Receive, read, and ask questions about this notice.

• Ask us to restrict certain uses and disclosures. You must deliver this request in writing to us. We are not required to grant the request, but we will attempt to comply with each request.

• Request and receive from us the most current Notice of Privacy Practices.

• Request that you are allowed to see and get a copy of your protected health information.

• Ask us to change your health information. You may write a statement of disagreement if your written request is denied. It will be stored in your medical record and included with any release of records.

• When you request, we will give you a list of disclosures of your health information. The list will not include disclosures to third-party payers.

• Ask that your health information be given to you by another means or at another location. We require a signed and dated written notice.

• Cancel prior authorizations to use or disclose health information by giving us a written revocation. Your revocation does not affect information that has already been released. It also does not affect any action taken before we have it. Sometimes, you cannot cancel an authorization if its purpose was to obtain insurance.

Skill Builders for Kids Responsibilities

1. We are required to give you this notice.
2. We are required to keep your protected health information private.
3. We are required to follow the terms of this notice.

Complaints or Help

You may file a complaint with us or with the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may contact us for help with these rights, or file a complaint with us by notifying our Privacy Officer. We will not retaliate against you for filing a complaint.

You may contact our Privacy Officer at 786.242.5710 or by e-mail at info@SbforKids.com.

This notice was published and became effective on April 14, 2003.