WILSON ORTHOPAEDIC SURGERY AND NEUROLOGY CENTER, P.A.
SUMMARY OF NOTICE OF PRIVACY PRACTICES
EFFECTIVE DATE: April 14, 2003

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.

USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION

We may use and disclose your health information:

• To treat you;
• To get paid;
• To remind you of appointments; and
• As may be required or otherwise permitted by law.

For more information on how we may use or disclose your health information, please refer to the full version of this Notice or contact our Privacy Officer.

We will use or disclose your health information for other purposes only with your authorization. If you authorize us to use or disclose your protected health information for other purposes, you may revoke that authorization at any time by notifying us.

YOUR RIGHTS WITH RESPECT TO YOUR PROTECTED HEALTH INFORMATION

You have the right to:

• Ask us to limit the information that we share;
• Receive confidential communications from us regarding your health information;
• Look at and obtain a copy of your health information;
• Amend mistakes in your health information;
• Obtain a list of the disclosures of your health information that we have made; and
• Obtain a copy of the full version of our Privacy Practices.

For more information on how to exercise your rights and how such rights may be limited by law, please refer to the full version of the Notice or contact our Privacy officer.

OUR DUTIES WITH RESPECT TO YOUR PROTECTED HEALTH INFORMATION

We are required by law to maintain the privacy of your protected health information, to provide you with notice of our legal duties with respect to your protected health information and our privacy practices, and to abide by the terms of our Notice of Privacy Practices.

REVISIONS TO NOTICE OF PRIVACY PRACTICES

We may revise our policies with respect to the privacy of patient health information from time to time. Any amendments to our Notice shall be posted in our office and copies of any amended Notice will also be available in our office.

Complaints

If you believe your privacy has been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. For more information on how to file a complaint, please refer to the full version of this Notice or contact our Privacy Officer.

PRIVACY OFFICER CONTACT INFORMATION

If you have any questions regarding your privacy rights, please refer to the full version of the Notice or contact our Privacy Committee at (252) 243-9629. You also may address questions or concerns to the Privacy Officer by writing to: Privacy Officer, P.O. Box 3148, Wilson N.C. 27895.