Healthcare Privacy Policy

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NOTICE OF PRIVACY PRACTICES

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.

This notice is to explain the rules around the privacy of your own medical/health records and our legal duties on how to protect the privacy of your medical/health records that we create or receive. Generally, we are required by law to ensure that medical/health information that identifies you is kept private. We are required by law to follow the terms of the notice that are the most current.

This notice will explain:
  • how we may use and disclose your medical/health information,
  • our obligations related to the use and
  • your rights related to any medical/health information that we have about you.


  • This notice applies to the medical/health records that are generated in or by Independence Center. The terms “medical” and “medical/health” in this Notice means information about your physical or mental condition which make you eligible for our services, or which arise while we are serving you. For example, this may include psychiatric assessments or medical or social assessments.

    We may obtain, but we are not required to, your consent for the use or disclosure of your protected health information for treatment, payment or health care operations. We are required to obtain your authorization for the use or disclosure of your information for other specific purposes or reasons. We have listed some of the types of uses or disclosures below. Not every possible use or disclosure is covered, but all of the ways that we are allowed to use and disclose information will fall into one of the categories.

    If you have any questions about the content of this Notice of Privacy Practices, or if you need to contact someone at Independence Center about any of the information contained in this Notice of Privacy Practices, the contact person is the Privacy Officer or designee:

    Peter Engel
    Independence Center Medical Records Custodian
    4245 Forest Park Ave.
    St. Louis, MO 63108
    (314) 880-5420

    In addition to all of the people that work or volunteer at Independence Center, the following people will also follow the practices described in this Notice of Privacy Practices:
  • Any health care professional who is authorized to enter information in your medical/health record.
  • Any member of a volunteer group that we allow to help you while you are at Independence Center;
  • All providers that Independence Center contracts with to provide services to our participants.


  • These other individuals or providers are considered a part of Independence Center and should follow the terms of this Notice of Privacy Practices. In addition, individuals and providers who a part of Independence Center may share medical information with each other about Independence Center participants they serve in common for the purpose of treatment, payment or health care operations as those terms are described later in this Notice of Privacy Practices.

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