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.

IF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT CUMBERLAND MEDICAL CENTER’S PRIVACY OFFICER, LISA HILD AT (931) 459-7207.

Protected Health Information (PHI) is information, including demographic information, that may identify you and that relates to health care services provided to you, the payment of health care services provided to you, or your physical or mental health or condition, in the past, present or future. It also describes your rights to access and control your PHI. As a hospital we are required by Federal law to maintain the privacy of PHI and to provide you with this notice of our legal duties and privacy practices.

We are required to abide by the terms of this Notice of Privacy Practices, but reserve the right to change the Notice at any time. Any change in the terms of this Notice will be effective for all PHI that we are maintaining at that time. If a change is made to this Notice, a copy of the revised Notice will be provided to all individuals covered under the plan at that time.

We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices by accessing our website at www.cmchealthcare.org , requesting that a revised copy be sent to you in the mail or asking for one at the time of your visit.

• Permitted Uses and Disclosures Treatment, Payment and Health Care Operations
  
• Other Uses and Disclosures Allowed Without Authorization
  
• Your Rights In Relation to Protected Health Information
  
• Complaints
  

This notice was published and becomes effective on March 12, 2003.