THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION

PLEASE REVIEW IT CAREFULLY. THE PRIVACY OF YOUR HEALTH INFORMATION IS IMPORTANT TO US.

OUR LEGAL DUTY
We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, our legal duties and your rights concerning your health information. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect April 14, 2003 and will remain in effect until we replace it.

We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information that we maintain, including health information we created or received before we made the changes. Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available upon request.

You may request a copy of our Notice at any time. For more information about our privacy practices or for additional copies of this Notice, please contact us using the information listed at the end of this Notice.

USE AND DISCLOSURE OF MEDICAL INFORMATION
This Practice will use and disclose health information about you for medical treatment, payment and healthcare operations. For example:

Treatment: We may use or disclose your health information to a physician or other healthcare provider who is providing treatment to you.

Payment: Your health information may be used or disclosed to receive payment for services we have provided to you.

Healthcare Operations: We may use or disclose your health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities.

Your Authorization: In addition to use of your health information for treatment, payment or healthcare operations, you may give us written authorization to use your health information or disclose it to anyone for any purpose. If you give us authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give us written authorization, we cannot use or disclose your health information for any reason except those described in this Notice.

To Your Family and Friends: We must disclose your medical information to you as described in the Patient Rights section of this Notice. We may disclose your health information to a family member, friend or any other person to the extent necessary to help you with your healthcare or with payment for your treatment only if you agree we may do so. However, only those family and friends you have specifically named in writing will be allowed to receive the health information.

Persons Involved In Care: We may use or disclose medical information to notify or assist in the notification of (including identifying or locating) a family member, your personal representative or other person(s) responsible for your care, of your location, your general condition or death. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of your inability or emergency circumstances, we will disclose your health information based on a determination using our professional judgment disclosing only health information that is directly relevant to the individual's involvement in your healthcare. We will also use our professional judgment and our experience with common practices to make reasonable inferences of your best interest in allowing a person to pick up your prescriptions, medical supplies, x-rays or similar forms of health information.

Minors: Patients who are under 18 years of age must have a legal guardian or parent acting on behalf of the patient, including authorizing who may have the minor's health information disclosed to them. Only a court order can alter this parental/guardianship authority.

Marketing Health-Related Services: This Practice will not use your health information for marketing communications without your written authorization.

Required by Law: We may use or disclose your health information when we are required to do so by law.

Abuse or Neglect: We may disclose your health information to appropriate authorities if we reasonable believe that you are a possible victim of abuse, neglect or domestic violence or the possible victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others.

National Security: The Practice may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence and other national security activities. We may disclose to a correctional institution or law enforcement official having lawful custody of protected health information of inmate or patient under certain circumstances.

Lawsuits and Disputes: If you are involved in a lawsuit or dispute, we may disclose medical information about you in response to a court or administrative order, subpoena, discovery request or other lawful process. We may also use such information to defend ourselves or any member of our Practice in any actual or threatened legal action.

Patient Recall Reminders: We may use or disclose your name, address, and appointment information in order to provide you with appointment reminders; such as voicemail messages, postcards or letters.

PATIENT RIGHTS
Access: You have the right to look at or receive copies of your health information with limited exceptions. You must submit your request in writing to obtain access to your health information. You may obtain a form to request access by using the contact information listed at the end of this Notice. We may charge a fee for the costs of copying, mailing or other activities associated with your request. You may also request access by sending a letter to the address at the end of this Notice. We reserve the right to deny your request to inspect and copy information in limited circumstances.

Disclosure Accounting: You have the right to receive a list of instances in which we or our business associates disclosed your health information for purposes, other than treatment, payment, healthcare operations and certain other activities for the last 6 years, but not before April 14, 2003. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests.

Restrictions: You have the right to request that we place restrictions on our use or disclosure of your medical information. Please note, however, we are not required to agree to these restrictions; but if we do, we will abide by our agreement (except in an emergency).

Alternative Communication: You have the right to request that we communicate with you about your health information by alternative means or to alternative locations. This request must be submitted in writing and must specify the alternative means or location and provide satisfactory explanation how payments will be handled under the alternative means or location you request.

Amendments: You have the right to request that we amend your health information. This request must be submitted in writing along with an explanation of why the information should be amended. We may deny your request under certain circumstances.

Electronic Notice: If you receive this Notice on our web site or be electronic mail, you are entitled to receive this Notice in written form.

QUESTIONS AND COMPLAINTS
To receive more information about our privacy practices or have questions/concerns, please contact:

Compliance Officer: Thomas Carothers, MD
Practice Administrator: Brenda Payne
Telephone: 513-791-6611
Fax: 513-791-6788
Address: 10457 Montgomery Rd, Suite 400 Cincinnati, OH 45242

If you are concerned that we may have violated your privacy right, you disagree with a decision we made about access to your health information, a response to a request you made to amend or restrict the use of disclosure of your health information, to have us communicate with you by alternative means or at alternative locations, you may complain to us using the contact information listed above. You may also submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request.

We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.