Privacy Policy Agreement
Cherry Blossom Buds
Notice of Privacy Practices for Cherry Blossom Buds
This notice is effect as of January 10, 2024
Natural Family Planning and Cycle Awareness Instructors collect, store, and transmit Personal Health Information (PHI) in conjunction with registration, educational and consultation services, and chart review. Per the HIPAA Act, we must protect the privacy, confidentiality, and security of our clients’ PHI and disclose to our clients how we use their information. This notice will explain how we use and disclose PHI and how our clients may access their PHI. Cherry Blossom Buds reserves the right to amend and update our Privacy Policy, as needed, and posts the most current document on our website for viewing.
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The privacy, confidentiality, and security of our clients’ PHI is important to us.
How we may use PHI
We collect information from our clients upon class registration and during consultations. We use this information to assist the client with chart interpretation and monitoring reproductive health. When necessary and with the client’s permission only, Cherry Blossom Buds Instructors may share your PHI with one another when collaborating on a chart review, when transferring a client from one instructor to another instructor, for the purposes of a teacher training session, or when communicating with a healthcare provider, dietician, or nutritionist during the course of a medical referral.
We will use the contact information that the client provides to us to schedule and confirm appointments, answer questions, and send feedback regarding a chart review or consultation. When contacting a client via telephone, we may leave a message with a member of the household who answers the call or on the client’s answering machine. Prudential judgment will always be used regarding disclosure of information when leaving a message.
Each instructor registers her clients with Cherry Blossom Buds nationally. This means that the mother’s name, mother’s email, daughter’s name, and cycle awareness course are sent securely to the director of Cherry Blossom Buds. This information is recorded and stored securely to verify program registration in the event that a client’s instructor ceases to offer consultations, either temporarily or permanently. Our national register verifies program registration and eligibility for consultation services with another instructor. Cherry Blossom Buds will also use this information to register each client for our email updates. Clients can easily unsubscribe from these updates, if they do not wish to receive them.
A client may revoke permission for her PHI to be used, at any time.
How we do not use PHI
We do not sell a client’s name, address, or telephone number to anyone for marketing purposes, or for any other reason. We do not share a client’s PHI within our organization or outside of our organization without the client’s permission.
Client access to PHI
Clients may request restriction on how their PHI is used or disclosed, receive confidential communications (as permitted by law), inspect and copy PHI, amend PHI (as permitted by law), and request and receive an account of disclosure of their PHI. The client can request access to their PHI with a written request to the client’s instructor or to the director of Cherry Blossom Buds. The client can read our Notice of Privacy Practices at www.cherryblossombuds.com and/or we will send a paper copy, when requested. If a client feels that her privacy rights have been violated, she may contact the director of Cherry Blossom Buds at [email protected] and/or file a complaint with the Secretary of Health and Human Services. Client will not be retaliated against for filing a complaint. (The information in this paragraph as been adapted from https://compliancy-group.com/hipaa-notice-of-privacy-practices, accessed 2024).
Complaints can be filed with the Secretary of Health and Human Services at https://www.hhs.gov/hipaa/filing-a-complaint/index.html
Responsibilities and Limitations of Confidentiality
Cherry Blossom Buds must follow the policy written in the current Notice of Privacy Practices. However, Cherry Blossom Buds may be required to disclose information in situations required by law. If a security breach occurs, Cherry Blossom Buds must notify all persons affected.
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Contact Information
Kelly Donahue
Director
Cherry Blossom Buds
Acknowledgment and Consent
I understand and agree to the Cherry Blossom Buds Privacy Policy and consent to allow Cherry Blossom Buds and its affiliated instructors to use my Personal Health Information, as described by the policy. I understand that I may revoke my consent to this agreement at any time, and I will notify Cherry Blossom Buds in writing if I choose to revoke consent.
I release Cherry Blossom Buds and its affiliated instructors from all liability and damages if a security breach occurs when my Personal Health Information is used and disclosed lawfully.
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Printed Name __________________________________________
Date __________________________