NOTICE OF PRIVACY PRACTICES
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H. For Organ, Eye or Tissue Donation: Four Seasons may use or disclose your health information to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of facilitating the donation and trans - plantation. I. For Research Purposes: Four Seasons may, under very select circumstances, use your health information for research. Before Four Seasons discloses any of your health information for such research purposes, the project will be subject to an extensive approval process. Four Sea- sons will ask your permission before any researcher will be granted access to your individually identifiable health information. J. In the Event of a Serious Threat to Health or Safety : Four Seasons may, consistent with appli- cable law and ethical standards of conduct, disclose your health information if Four Seasons, in good faith, believes that such disclosure is necessary to prevent or lessen a serious and im- minent threat to your health or safety or to the health and safety of the public. K. For Specified Government Functions: In certain circumstances, the Federal regulations author - ize Four Seasons to use or disclose your health information to facilitate specified government functions relating to military personnel and veterans, national security and intelligence activi - ties, protective services for the President and others, medical suitability determinations, and inmates and law enforcement custody. L. For Worker’s Compensation: Four Seasons may release your health information for Worker’s Compensation or similar programs. IV. AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION Other than as stated above, Four Seasons will not disclose your health information without your written authorization. If you or your representative authorizes Four Seasons to use or disclose your health information, you may revoke that authorization in writing at any time, except to the extent that Four Seasons has already acted upon your authorization. Four Seasons will obtain your authorization prior to: (a) disclosing your Psychotherapy Notes, if applicable; (b) using your health information for most marketing communications, except face-to-face communications, whenever Four Seasons is paid by a third party for making such communications; or (c) disclosing your health information in a manner which constitutes the sale of such information under the Health Informa - tion Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations. V. YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION You have the following rights regarding your health information maintained by Four Seasons: A. Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of your health information. For example, you may request a limit on Four Seasons’ disclosure of your health information to someone who is involved in your care or the payment of your care. All requests for restrictions must be made in writing using the appropriate Four Seasons form. Except in limited circumstances, Four Seasons is not required to agree to your request. Except as otherwise required by law, Four Seasons must agree to a restriction request if: (i) the disclosure is to a health plan for purposes of carrying out payment or health care operations (and not for purposes of carrying out treatment); and (ii) the health information pertains solely to a health care item or service for which you, or another person other than the
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