Your Information. Your Rights.
Our Responsibilities.

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.

If you have any questions about this notice, please contact Erica Borsum, Assistant Manager of Healthcare Services of Michigan Center for Holistic Medicine at (616) 264-6556, or 638 W. Fulton Street, Suite B, Grand Rapids, MI 49504.

Your medical information is personal. Michigan Center for Holistic Medicine is committed to protecting your medical information. We create a record of the care and services you receive at this office. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this office whether made by your personal physician or one of the office’s employees.

This Notice will tell you about the ways in which we may use and disclose your medical information. This Notice will also describe your rights and certain obligations we have regarding the use and disclosure of your medical information.

Section I: Your Rights
Section II. Your Choices
Section III. Our Uses and Disclosures
Section IV. Our Responsibilities

Section I: Your Rights
Section II. Your Choices
Section III. Our Uses and Disclosures
Section IV. Our Responsibilities

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

** If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. **

**We never market or sell personal medical information**  

Our Uses and Disclosures

How do we typically use or share your health information?

We typically use or share your health information in the following ways.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.

For more information visit the United State Health and Human Service website.

Changes to the Terms of this Notice: We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site