Audiology Doctors of Tulsa (ADT) is committed to protecting the privacy of your health care information, as federal and state laws require.  By “information”, we mean health, treatment, or payment information that identifies you.  Such information is also referred to as “protected health information” (PHI).  The ADT Notice of Privacy Practices (Notice) explains how we protect your privacy and also explains your legal rights about the information in your health record.  All employees and office sites of ADT must follow the Notice.  This summary tells you briefly what the Notice says and is not a complete account of how we share your health information.  ADT has the right to change this Summary and the Notice without first notifying you. Please contact ADT for a copy of the Notice.

How ADT (we) may use and share (disclose) your health information

Without your consent, ADT can use and share your health information to:

  • Provide you with medical treatment and other services related to your treatment
  • Receive payments from you, an insurance company, or someone else for services we provide to you
  • Operate ADT, which includes such things as giving you appointment reminders, telling you about other treatment options, and contacting you for certain marketing activities
  • Comply with the law
  • Conduct research, only if approved as necessary and appropriate by a review board (also called an Institutional Review Board), which is obligated to protect human rights in research
  • Cooperate in special situations, such as public health, safety, and disaster relief efforts

Exception:  This does not include information about behavioral health, drugs and alcohol, and AIDS/HIV.

With your agreement, ADT can:

  • Share your health information with family or friends you agree can have this information
  • All other uses and sharing of your health information will be done only with your specific permission or as required by law

Your legal rights about your health information

  • Right to ask to see and copy your medical record
  • Right to ask that we correct any information that is incorrect or incomplete
  • Right to ask for a list of people or organizations, other than ADT, with whom we shared your information.  You do not have a right to request this list in the following two circumstances:

-If we had your written permission to share
the information.
-If we shared information to carry out
treatment, payment, and health care

  • Right to ask ADT to restrict how we use and share your information without your consent.  ADT is not required to agree to your request.
  • Right to ask for confidential communications
  • Right to ask for a paper copy of the Notice of Privacy Practices

If you believe your privacy rights have been violated, you have a right to file a complaint.  Please refer to the Notice for details.