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.

Protected health information (“PHI”) is stored electronically and may be subject to electronic disclosure.

If you have any questions about this notice, please contact the Axis Healthcare at (918) 943-3790.

This Notice Describes the Privacy Practices of:

• Any physician, nurse practitioner, physician assistant, or other healthcare professional involved in
  your care;
• Any employee, contractor, trainee, or volunteer permitted to assist in your care; and
• All Axis Healthcare clinics, departments, and affiliated entities.

All such individuals and entities follow the terms of this notice and may share your protected health
information with one another for treatment, payment, and healthcare operations as described below.

Our Pledge Regarding Health Information

We understand that health information about you and your health is personal. Axis Healthcare is committed
to protecting your medical information. This notice explains how we may use and disclose your health
information, your rights regarding that information, and our legal responsibilities. We comply with all
applicable federal and state privacy laws, including HIPAA, and any state laws that provide additional
privacy protections.

We Are Required by Law To:

• Maintain the privacy of your protected health information;
• Provide you with this notice of our legal duties and privacy practices;
• Abide by the terms of the notice currently in effect; and
• Notify affected individuals in the event of a breach involving unsecured protected health information.

How We May Use and Disclose Your Health Information

For Treatment
We may use and disclose your health information to provide, coordinate, or manage your healthcare. This includes sharing information among physicians, nurses, specialists, laboratories, pharmacies, and other healthcare providers involved in your care.

For Payment
We may use and disclose your health information to bill and collect payment for services provided. This may include disclosures to health plans, insurance companies, or billing services to determine eligibility, process claims, or collect amounts owed.

For Healthcare Operations
We may use and disclose your health information for operational purposes, including quality improvement, staff evaluation, training, accreditation, legal services, auditing, and business planning to ensure high-quality care.

Health Information Exchange
Axis Healthcare may participate in one or more health information exchanges (HIEs) and may use or disclose your information through these systems to coordinate care, process payments, or improve healthcare quality.

Facility Directory
Unless you object, we may include limited information (such as your name, location, and general condition) in a facility directory. This information may be shared with individuals who ask for you by name.

Individuals Involved in Your Care
We may disclose relevant information to family members, friends, or others you identify who are involved in your care or payment for care. We may also disclose information for disaster relief efforts.

Appointment Reminders and Communication
We may contact you for appointment reminders, follow-up care, billing matters, or to inform you of treatment alternatives. Messages may be left via voicemail, text, or other communication methods unless you request otherwise.

Fundraising
Axis Healthcare does not use or disclose your information for fundraising purposes.

Uses and Disclosures Required or Permitted by Law
We may disclose your health information without your authorization for:

• Public health activities;
• Reporting abuse, neglect, or domestic violence;
• Health oversight activities (audits, investigations, inspections);
• Judicial or administrative proceedings;
• Law enforcement purposes;
• Organ, eye, or tissue donation;
• Research (with authorization or appropriate approval);
• To prevent a serious threat to health or safety;
• Government and military functions;
• Workers’ compensation claims;
• To business associates who perform services on our behalf and agree to protect your information.

Other Uses and Disclosures
Except as described above, we will only use or disclose your health information with your written authorization. We do not sell your health information or use it for marketing purposes without yourauthorization. You may revoke an authorization in writing at any time, except where action has already been taken in reliance on it.

Your Rights Regarding Health Information
You have the right to:

• Receive a paper copy of this notice;
• Inspect and obtain a copy of your health information;
• Request amendments to your health information;
• Request confidential communications;
• Receive an accounting of disclosures;
• Request restrictions on certain uses or disclosures (subject to legal limits).

If another individual has legal authority to act on your behalf, that person may exercise these rights after appropriate verification.

To exercise your rights, contact the Axis Healthcare Privacy Officer.

Changes to This Notice
Axis Healthcare reserves the right to change this notice and make the revised notice effective for all health information we maintain. Updated notices will be posted in our facilities and on our website at www.axishealth.net.

Complaints 
If you believe your privacy rights have been violated, you may file a complaint with Axis Healthcare or with the U.S. Department of Health and Human Services. You will not be penalized for filing a complaint.

Contact Information

Axis Healthcare
Attn: Medical Records
11911 S. Memorial Dr.
Bixby, OK 74008
Phone: 918-943-379