For Patients

Your Rights Regarding Your Health Information

You have the following rights regarding health information we maintain about you:

Right to Request Restrictions:
You have the right to request restrictions on how we use and disclose your health information for treatment, payment or health care operations. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
To request restrictions, you must make your request in writing and submit it to:

Privacy Official
Virginia Oncology Associates
5900 Lake Wright Drive
Norfolk, VA 23502

Right to Request Confidential Communications:
You have the right to request that we communicate with you in a certain manner or at a certain location regarding the services you receive from us. For example, you may ask that we only contact you at work or only by mail.

To request confidential communications, you must make your request in writing and submit it to:

Privacy Official
Virginia Oncology Associates
5900 Lake Wright Drive
Norfolk, VA 23502

We will not ask you the reason for your request. We will attempt to accommodate all reasonable requests.

Right to Inspect and Copy:
You have the right to inspect and copy health information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes or information that is compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding.
To inspect and copy your health information, you must make your request in writing by filling out the appropriate form provided by us and submitting it to:

Privacy Official
Virginia Oncology Associates
5900 Lake Wright Drive
Norfolk, VA 23502

If you request a copy of your health information, we may charge a fee for the costs of copying, mailing or preparing the requested documents. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to your health information, you may request that the denial be reviewed by a licensed health care professional chosen by us. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

Right to Amend:
If you feel that your health information is incorrect or incomplete, you may request that we amend your information. You have the right to request an amendment for as long as the information is kept by or for us.

To request an amendment, you must make your request in writing by filling out the appropriate form provided by us and submitting it to:

Privacy Official
Virginia Oncology Associates
5900 Lake Wright Drive
Norfolk, VA 23502

We may deny your request for an amendment. If this occurs, you will be notified of the reason for the denial and given the opportunity to file a written statement of disagreement with us.

Right to an Accounting of Disclosures:
You have the right to request an accounting of certain disclosures we make of your health information. Please note that certain disclosures, such as those made for treatment, payment or health care operations, need not be included in the accounting we provide to you.

To request an accounting of disclosures, you must make your request in writing by filling out the appropriate form provided by us and submitting it to:

Privacy Official
Virginia Oncology Associates
5900 Lake Wright Drive
Norfolk, VA 23502

Your request must state a time period which may not be longer than six years, and which may not include dates before April 14, 2003. The first accounting you request within a 12-month period will be free. For additional accountings, we may charge you for the costs of providing the accounting. We will notify you of the costs involved and give you an opportunity to withdraw or modify your request before any costs have been incurred.

Right to a Paper Copy of This Notice:
You have the right to a paper copy of this Notice at any time, even if you previously agreed to receive this Notice electronically.

To obtain a paper copy of this Notice, please contact

Privacy Official
Virginia Oncology Associates
5900 Lake Wright Drive
Norfolk, VA 23502

You may also obtain a paper copy of this Notice at our web site, www.virginiacancer.com

Right to Complain:
If you have any questions about this Notice or would like to file a complaint about our privacy practices, please direct your inquiries to:

Privacy Official
Virginia Oncology Associates
5900 Lake Wright Drive
Norfolk, VA 23502

You may also file a complaint with the Secretary of the Department of Health and Human Services. You will not be retaliated against or penalized for filing a complaint.

United in Healing with the US Oncology Network