Patient Privacy (HIPAA)


Notice of Privacy Practices for Protected Health Information (45 CFR 164.520)

The Practice of Sound Family Medicine is required by applicable federal and state laws to maintain the privacy of your health information. Protected health information (PHI) is the information we create and maintain in the course of providing our services to you. Such information may include documentation of your symptoms, examination and test results, diagnoses and treatment protocols. It also may include billing documents for those services.

We are permitted by federal privacy law (the Health Insurance Portability & Accountability Act of 1996 (HIPAA), to use and disclose your PHI, without your written authorization, for purposes of treatment, payment, and health care operations.

  • Examples of Using Your Health Information for Treatment Purposes:
    Our nurse obtains treatment information about you and records it in your medical record;
  • During the course of your treatment, the physician determines if there is a need to consult with a the physician will share the information with the specialist and obtain his/her input;
  • We may contact you by phone or at your home if we need to speak to you about a medical condition, or to remind you of medical
  • Sound Family Medicine is part of a HIPAA organized health care arrangement (“OHCA”) with participating providers of the Physician Care Alliance.  As participants in the OHCA, Sound Family Medicine and the other OHCA participants engage in quality assessment and improvement activities through which treatment provided by each organization is assessed by the other participants. As permitted by HIPAA, Sound Family Medicine may share the health information of its patients with the OHCA participants when necessary for health care operations purposes of the OHCA.

Example of Using Your Health Information for Payment Purposes:

  • We submit requests for payment to your health insurance We will respond to health insurance company requests for information from about the medical care we provided to you.

Example of a Using Your Information for Health Care Operations:

  • We may use or disclose your PHI to conduct certain business and operational activities, such as quality assessments, employee reviews, or student We may share information about you with our business associates, third parties who perform these functions on our behalf, as necessary to obtain their services.

Our Responsibilities

The Practice is required to:

  • Maintain the privacy of your health information as required by law;
  • Notify you following a breach of your unsecured PHI;
  • Provide you with a notice (‘Notice’) describing our duties and privacy practices with respect to the information we collect and maintain about you and abide by the terms of the Notice;
  • Notify you if we cannot accommodate a requested restriction or request; and,
  • Accommodate your reasonable requests regarding methods for communicating with you about your health information and comply with your written request to refrain from disclosing your PHI to your health plan if you pay for an item or service we provide you in full and out-of-pocket at the time of

We reserve the right to amend, change, or eliminate provisions of our privacy practices and to enact new provisions regarding the PHI we maintain about you. If our information practices change, we will amend our Notice. You are entitled to receive a copy of the revised Notice upon request by phone or by visiting our website or Practice.

Other uses and disclosures of your PHI not described in this Notice will only be made with your authorization, unless otherwise permitted or required by law.  Most uses and disclosure of psychotherapy notes, uses and disclosures of your PHI for marketing purposes, and disclosures of your PHI that constitute a sale of PHI will require your authorization. You may revoke any authorization at any time by submitting a written revocation request to the Practice (as previously provided in this Notice under “Your Health Information Rights.”)

To Request Information, Exercise a Patient Right or File A Complaint

If you have questions, would like additional information, want to exercise a Patient Right described above, or believe your (or someone else’s) privacy rights have been violated, you may contact the Practice’s Privacy Officer at 253-848-5951, or in writing to us at:

Privacy Officer
Sound Family Medicine
3908 10th St SE
Puyallup, WA 98374

Please note that all complaints must be submitted in writing to the Privacy Officer at the above address. You may also file a complaint with the Secretary of Health and Human Services (HHS), Office for Civil Rights (OCR). Your complaint must be filed in writing, either on paper or electronically, by mail, fax (253-845-7073), or email. More information regarding the steps to file a complaint can be found at:

  • We cannot, and will not, require you to waive the right to file a complaint with the Secretary of HHS as a condition of receiving treatment from the practice.
  • We cannot, and will not, retaliate against you for filing a complaint with the Secretary of HHS.