Temple Community
Free Clinic Serving
the community since 1992. (254) 771-3374 1905
Curtis B Elliott Dr., Temple, TX76501
HIPAA Notice of Privacy Practices
Temple
Community Free Clinic
Summary HIPAA Notice of Privacy Practices
The Temple Community Free Clinic complies with the Health Insurance
Portability and Accountability Act of 1996 (HIPAA). The Temple
Community Free Clinic protects confidential health care information,
known as “Protected Health Information” (PHI). Below is a
summary of your privacy rights under HIPAA. The Temple Community
Free Clinic legal duties and privacy practices regarding your
PHI are also included in this Summary Notice.
Summary of Your Privacy Rights
The Temple Community Free Clinic may use and give your health
information to:
• Treat you
• Get paid
• Operate health care services
The Temple Community Free Clinic may use and give your health
information for:
• Law enforcement requests
• Judicial and administrative proceedings related to legal
actions
• Healthcare fraud and abuse detection or compliance with the
law
• Use by another healthcare provider treating you
• Government health oversight activities
• Reports required by law related to births, deaths or diseases
• Reports required by law related to neglect and abuse, or
domestic violence
• Notifying a party about exposure to a possible communicable
disease
• Use by another healthcare provider for payment to that provider
• Military, national defense and security or other governmental
functions
• Workers’ compensation purposes and in compliance with related
laws
• Averting a serious threat to public health and safety
You have the right to:
• Inspect or get a copy of your medical record
• Change information on your medical record if you think it
is incorrect
• Get a list of persons whom The Temple Community Free Clinic
shared your PHI
• Ask The Temple Community Free Clinic to limit the information
it shares
• Ask for a copy of your privacy notice
• Write a letter of complaint to The Temple Community Free
Clinic or the federal government
If you have any questions or if you wish to file a complaint,
or exercise any rights listed in this Summary or the complete
Notice, please contact the Temple Community Free Clinic
Privacy Officer at the telephone number listed below.
