Common use of Requesting Restrictions Clause in Contracts

Requesting Restrictions. You have the right to request a restriction in our use or disclosure of your PHI for treatment, payment or health care operations. Additionally, you have the right to request that we restrict our disclosure of your PHI to only certain individuals involved in your care or the payment for your care, such as family members and friends. We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you. In order to request a restriction in our use or disclosure of your PHI, you must make your request in writing to Xxxxx Xxxxxxx, M.D. Your request must describe in a clear and concise fashion: (a) the information you wish restricted; (b) whether you are requesting to limit our practice’s use, disclosure or both; and (c) to whom you want the limits to apply.

Requesting Restrictions. You have the right to request a restriction in our use or disclosure of your PHI for treatment, payment or health care operations. Additionally, you have the right to request that we restrict our disclosure of your PHI to only certain individuals involved in your care or the payment for your care, such as family members and friends. We are not required to agree to your request; request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, emergencies or when the information is necessary to treat you. In order to request a restriction in our use or disclosure of your PHI, you must make your request in writing to Xxxxx Xxxxxxx, M.D. the “Privacy Officer” designated above. Your request must describe in a clear and concise fashion: (a) the • The information you wish restricted; (b) whether , • Whether you are requesting to limit our practice’s use, disclosure or both; and (c) to , • To whom you want the limits to apply.

Requesting Restrictions. You have the right to request a restriction in our my use or of disclosure of your PHI for treatment, payment payment, or health care operations. Additionally, you have the right to request that we I restrict our my disclosure of your PHI to only certain individuals involved in your care or the payment for your care, such as family members and friends. We are I am not required to agree to your request; however, if we I do agree, we are I am bound by our agreement except when otherwise required by law, in emergencies, emergencies or when the information is necessary to treat you. In order to request a restriction in our my use or of disclosure of your PHI, you must make your request in writing to Xxxxx XxxxxxxXxxxxx Xxxxxx at xxxxxx@xxxxxxxxxxxxxxxxxxxx.xxx, M.D. (000) 000-0000. Your request must describe in a clear and concise fashion: (a) the ● The information you wish restricted; (b) whether , ● Whether you are requesting to limit our practice’s my practices use, disclosure or both; and (c) to , ● To whom you want the limits to apply.