Effective Date: March 1st, 2016


Individuals under 18 years of age must have a parent or guardian sign on your behalf and take care of your privacy rights for you.

 If you have any questions about this Notice, please contact our Privacy Officer, Aixa Garcia at 407-599-1111


Simple Way Care practice and the practice of:

Any physician and/or mid-level provider employed by Simple Way Care LLC that is authorized to access your medical records
All departments and practice locations of Simple Way Care LLC
All employees, staff, and/or personnel of Simple Way Care LLC


We are committed to protecting medical information about you since we understand that medical information about you and your health is personal. Each time you visit our office a record of your visit is made. The information created and/or received about you, including demographic information, that may identify you and that is related to your past, present or future physical or mental health or condition and related health care services is called: protected health information (PHI). In addition to documentation of your symptoms, examination, test results, diagnoses, treatment, etc. protected health information (PHI) also includes billing and payment related documents for health care provided. This notice applies to all of the records of your health care created and/or maintained by Simple Way Care. In this notice you will be informed about the ways in which we may use and disclose medical information about you as well as your rights and obligations pertaining to the use and disclosure of medical information.

We are required by law to:

Use our best efforts to protect the privacy of your medical information
Provide you with this notice of our legal duties and privacy practices pertaining to medical information about you
Make a good faith effort to obtain your written acknowledgement for the receipt of this notice.
Let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
Follow the duties and privacy practices described in our current Notice of Privacy Practices and provide you a copy of it upon request.

Please be advised we may change the terms of our notice at any time. All existing protected health information will be subject to the new notice. We will provide you with a copy of the revised Notice of Privacy Practices, (if applicable) upon your request. You can contact our Privacy Officer at 407-599-1111 to request a copy or ask for one at the time of your appointment). 


We may share your medical information in any appropriate format that allows an efficient coordination for the treatment, payment, and health care operation of your medical care.
Information might be shared by paper, oral or electronic exchange/interchange.
Simple Way Care LLC may share medical information without your permission (which is called an authorization under HIPAA) for treatment, payment and/or practice operations purposes described in this notice.

The following categories provide information about the different ways in which we may use and disclose medical information pertaining to you. For each category of uses or disclosures we will explain what we mean and illustrate with some examples to help you understand the meaning.

For Treatment: We may use and disclose medical information about you to provide you with medical treatment and/or services including the coordination or management of your health care with another provider. We may disclose medical information about you to physicians, mid-level providers, nurses, technicians, medical students, specialists, or any other personnel who becomes involved in your care by providing assistance with your health care diagnosis and/or medical treatment. For example your medical information may be disclosed to another physician to whom you have been referred in order to provide that physician with the needed information to treat you. We may also share medical information about you with pharmacies, labs, diagnostic centers, etc. in order to appropriately coordinate prescriptions, lab orders, diagnostic testing, etc.
Payment: We may use and disclose medical information about you so that the treatment and services you receive from Simple Way Care LLC  may be billed and payment may be collected  For example we may disclose information about you with a third party billing company that takes care of our billing. This may also include certain verifications from your health insurance plan before it pays for the health care services recommended for you.
Health Care Operations: We may use and disclose medical information about you for Simple Way Care LLC’s operations. These uses and disclosures are necessary to run the practice and make sure that all of our patients receive quality care. For example, we may use medical information to evaluate the performance of our staff as a quality measure/assessment of your care. We may also use and disclose your information if needed for legal services and auditing purposes among others. We may also use medical information about you in order to support the business activities of our practice like training of medical students, licensing and fundraising among others. For example: we may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at Simple Way Care LLC.

Other Permitted Uses and Disclosures we may have of your information that do not require your authorization

Business Associates: We may give out your medical information to our business associates including but not limited to: consultants, lawyers, accountants, and other third parties that provide services to us. We require our business associates to protect the privacy and security of your protected health information (PHI) as per the terms and conditions set forth in a business associate agreement.
Treatment Alternatives: We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
Health-Related Benefits and Services: We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you. If you are not interested in receiving these materials, you may inform us by contacting our Privacy Officer.
Research: Under certain limited circumstances, we may use and disclose your medical information for research purposes. We may disclose your protected health information (PHI) to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and has established protocols to protect the privacy of your protected health information (PHI).
 Required By Law: We will disclose medical information about you when required to do so by Federal, State or Local law limiting the information to the relevant requirements of the law.
Prevention of a Serious Threat to Health or Safety: We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
Unless you object:

We may release medical information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location. If you do not want us to share information with your family or others involved in your care please contact Simple Way Care Privacy Officer.                 

Special Cases of use and disclosure of health care information

Military and Veterans: If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority. We may also disclose information to entities that determine eligibility for certain veterans’ benefits.
Workers’ Compensation: We may release medical information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Public Health: We may disclose your protected health information (PHI) for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. For example, we may disclose information for the purpose of preventing or controlling disease, injury or disability.
Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or be at risk of contracting or spreading the disease or condition
Lawsuits and Dispute: We may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Law Enforcement: We may release medical information if asked to do so by a law enforcement official:

In response to a court order, subpoena, warrant, summons, discovery request, or similar process
To identify or locate a suspect, fugitive, material witness, or missing person
About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement
About a death we believe may be the result of criminal conduct
About criminal conduct at Simple Way Care LLC
In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime

Coroners, Medical Examiners and Funeral Directors and organ donation: We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about our patients to funeral directors as necessary to carry out their duties Protected health information (PHI) may be used and disclosed for cadaveric organ, eye or tissue donation purposes

National Security and Intelligence Activities. We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law
Protective Services for the President and Others. We may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
Health Oversight Activities: We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws

4-Your Rights Regarding Medical Information about You

You have the following rights regarding medical information we maintain about you:

Right to Inspect and Copy. You have the right to inspect and copy some of the medical information that may be used to make decisions about your care. Usually, this includes medical and billing records.

Under Federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and laboratory results that are subject to law that prohibits access to protected health information (PHI). In some cases a decision to deny access may be reviewable depending on the circumstances.

When your medical information is contained in an electronic health record, as that term is defined in federal laws and rules, you have the right to obtain a copy of such information in an electronic format and you may request that we transmit such copy directly to an entity or person designated by you, provided that any such request is in writing and clearly identifies the person we are to send your protected health information (PHI) to. If you request a copy of the information, we may charge a fee for the costs of labor, copying, mailing or other supplies associated with your request. We may deny your request to inspect and copy medical information in certain circumstances. For any questions regarding access to your medical records please contact our Privacy Officer listed on page 1 of this notice.

Right to Amend: You may request an amendment if you believe that medical information we have about you is incorrect or incomplete for as long as the information is kept by or for the practice. The request must be in writing and provide a supporting reason for the request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

Was not generated by us, and/or cannot be changed by us, unless the person or entity that created the information is no longer available to make the amendment;
Is not included in medical information kept by and/or for the practice;
Is not part of the information which you would be permitted to inspect and copy; or
Is correct and complete

Right to a list of Disclosures. You have the right to request an “accounting of disclosures." This is a list of certain disclosures we made of medical information about you. The accounting will exclude certain disclosures as provided in applicable laws and rules such as disclosures made directly to you, disclosures you authorize, disclosures to friends or family members involved in your care, disclosures for notification purposes and certain other types of disclosures made to correctional institutions or law enforcement agencies. Your request must state a time period which may not be longer than six years. Your request should indicate in what form you want the list (for example: paper/ electronically). We will notify you if a charge for cost might applies.

Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. The request must be in writing and provide the type of restriction: use of information/disclosure of information/both; the specific information you want to restrict; and to whom you want the restriction to apply.

Your physician is not obligated to agree to a restriction request made by you. In cases where the physician agrees to the requested restriction, your protected health information (PHI),may not be used or disclosed in violation of that restriction with the exception of emergency treatment. For any questions about restriction requests or to place one please contact our Privacy Officer listed on page 1 of this notice.

 Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contract you at work or by mail. We will not ask the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to a Notice of Breach: You have the right to receive written notification of a breach if your unsecured medical information has been accessed, used, acquired or disclosed to an unauthorized person as a result of such breach, and if the breach compromises the security or privacy of your medical information. Unless specified in writing by you to receive the notification by electronic mail, we will provide such written notification by first-class mail or, if necessary, by such other substituted forms of communication allowable under the law.

Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.

5-Changes to This Notice

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in Simple Way Care LLC reception area, as well as on our website. The notice will disclose on the first page header the effective date.

6- Other Uses of Medical Information That Require Your Authorization

You may revoke authorizations to use or disclose medical information about you in writing, at any time. In the event you revoke your authorizations, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. Please be advised your revocation will be effective only after the date of the written revocation and never retroactive. We are not able to take back any disclosures we have already made with your permission; we are also required to retain our records for the medical care we provided you.

The following types of uses and disclosures of medical information will be made only with your written permission.

Psychotherapy Notes. Notes that your psychiatrist or psychologist maintains separate and apart from your medical record that require your written authorization for disclosure unless the disclosure is required or permitted by law, the disclosure is to defend the psychiatrist or psychologist in a lawsuit brought by you, or the disclosure is used to treat you or to train students.
Marketing. We are required to get your permission to use your medical information for marketing unless we are having a face-to-face talk about the new health care product or service, or unless we are giving you a gift to tell you about the new health care product or service. We must also tell you if we are getting paid by someone else to tell you about a new health care item or service.
Selling Medical Information. We are not allowed to sell your medical information without your permission and we must tell you if we are getting paid. Please be advised some activities like selling our business, paying our contractors and subcontractors, participating in research studies, receiving payment for treating you, etc., are not considered a sale of your medical information and therefore will not require your consent.
Use of Electronic Health Record System: Simple Way Care LLC uses an electronic health records system that is HIPAA compliant as a way of protecting your personal health information. We also offer a secure way to access your information and to communicate through an electronic patient portal. It is required that you sign an authorization before you can be invited or granted access to the electronic patient portal.

7-Unsecure Methods of Communication

Some methods of communication cannot reasonably be guaranteed to be fully secure or confidential including but not limited to web-based unencrypted email, website submissions, instant messaging, third-party online services, cell phone, text messaging, voicemail, fax, online video conference.
Although secure email messaging is the method recommended and preferred over unsecure email messaging for communication of protected health information, we offer, (not required) the use of unsecure email communication containing sensitive health information between Simple Way Care and the patient. In order for you or other designated person to communicate with us through the use of insecure email communications you are required to provide us with a written authorization.
In the event a patient initiates communications with a provider using e-mail, Simple Way Care LLC, its physicians and staff will understand (unless a written request from the patient has explicitly stated otherwise), that e-mail communications are acceptable to the patient.
If you elect to communicate from your workplace computer, you should be aware that your employer and its agents may have access to your email communications. We will not be liable for your use of employer-owned computers or emails.
It is not advisable to communicate health information about sensitive health topics like sexual related activities, HIV/AIDS, or substance abuse through unsecured methods of communication.
Personal or health information provided to us from the use of unsecured electronic methods may be made part of your medical records subject to the same stipulations of this Notice of Privacy Practices.


If you believe your privacy rights have been violated, you may file a complaint with the practice or with the Secretary of the Department of Health and Human Services.
To file a complaint with Simple Way Care LLC please contact our Privacy Officer Aixa Garcia by phone, fax, or in person:

407-599-1111 Tel

773-825-8331 Fax

All complaints must be submitted in writing. You will not be retaliated against for filing a complaint.