After filling out the form, you may hand deliver it to any of The Orthopedic Partners locations. The form can also be emailed to firstname.lastname@example.org or mailed to the address listed below:
The Orthopedic Partners
900 Round Valley Drive, Suite 100
Park City, UT 84060
Patients First: How We Protect Your Privacy
At The Orthopedic Partners, we are committed to providing you with the highest quality of care. An essential part of this commitment is our dedication to protecting the privacy and the confidentiality of your medical information.
Our patient privacy pamphlet has been prepared in response to federal regulations that enforce the Health Insurance Portability and Accountability Act of 1996, which is known by the acronym HIPAA. More recent regulations, effective April 14, 2003, set forth certain legal requirements regarding how healthcare providers must protect your medical information. To comply, our Clinic must provide you with a Notice of Privacy Practices, which describes how your medical information may be used and disclosed. This notice also discusses your rights as a patient under the law.
We encourage you to read the information contained in this handbook in its entirety. It will explain how The Orthopedic Partners may use and disclose your medical information and it will help you understand your rights as a patient. For your convenience, what follows is a summary of key provisions of this notice.
The Orthopedic Partners may use and disclose your medical information to:
You have a right to:
If you have any questions or would like to report a concern or problem regarding the handling of your medical information, please contact our Medical Records Department or Administration at (435) 655-6603.