PRIVACY POLICY

A Message from Shahrouz Sean Dadfarin MD, Inc.:

This Notice of Privacy Practices (“Notice”) explains how we may use your medical information, who we may share it with, and how to get a copy of your medical records.

OUR PROMISE REGARDING HEALTH INFORMATION

Shahrouz Sean Dadfarin MD, Inc. (“Medical Practice”) is committed to protecting your protected health information (“PHI”). This Notice explains how we safeguard your PHI for all of the health services you receive at the Medical Practice:

• Laws to protect your PHI
• Your rights about your PHI
• How to file a privacy-related complaint

We will always notify you of any breach (unauthorized use) of unsecured PHI that affects you.

The State of California has protected categories of health information that are kept and handled in special ways. This includes: mental health treatment, developmental disabilities treatment, drug/alcohol abuse treatment, and HIV/AIDS treatment information. It also includes information about the treatment of minors consenting for reproductive health and pregnancy, mental health, substance abuse, sexually transmitted diseases, rape, or sexual assault-related services.

CHANGES TO NOTICE OF PRIVACY PRACTICES

The Medical Practice follows all the privacy practices in this Notice. We also have the right to change these practices. If we make important changes, we will provide you with an updated Notice during your next visit to the Medical Practice. You can get a copy of this Notice from the Medical Practice site or online at  https://drdmymd.com/.

HOW DOES THE MEDICAL PRACTICE USE AND DISCLOSE PHI?

The Medical Practice will only use or share your PHI if it is needed to provide you with health services. Some of the information the Medical Practice uses and shares is as follows: your name, address, email, telephone numbers, health care history, health care provided to you, and the cost of your health care. The following are other examples of how the Medical Practice may use or disclose your PHI.

Treatment: The Medical Practice will use and share your PHI with doctors, hospitals, and others to provide, coordinate, or manage your health care and any related services. For example, we may need to use your PHI to get prior approval for certain services, to call you as a reminder about an upcoming appointment, or to follow your health changes.

Payment: The Medical Practice will use and share your PHI, as needed, to obtain or provide payment for your health care services. This may include sharing information with your insurance, provider, or personal representative who is responsible for making decisions about payment of services.

Health Care Operations: Your information may be used for general administrative purposes. For example, we may need to check how well we are providing services, as part of audits, to participate in programs to stop fraud, and for the Medical Practice planning needs.

OTHER USES OF YOUR PHI

Marketing: Most uses and sharing of your PHI for marketing purposes would require your prior written authorization. There are some exceptions to marketing such as when a communication describes a health-related product or service, or an announcement of new providers or equipment.

Fundraising: The Medical Practice may contact you to provide information about the Medical Practice sponsored activities such as fundraising programs and events or charity drives. The funds raised would be used to expand and improve the services and programs the Medical Practice can provide to the community.  To do so, the Medical Practice may use your contact information such as your name, address, phone number, date of birth, physician name, outcome of your care, site where you received a service, and the dates you received treatment or services at the Medical Practice. 

If you do not want to receive fundraising materials and would like to opt-out, please contact the Medical Practice by phone at (310) 734-4229 or email at assistant@drdmymd.com, or respond to any communication with a request to opt-out. You are free to opt-out fundraising communications at any time, and your decision will have no impact on your treatment or payment for services.

 To Individuals Involved in Your Care or Payment for Your Care: The Medical Practice may share PHI with family members or friends involved in decisions about your care, payment for care, or in the case of an emergency. You have the right to request that the Medical Practice not share some or all of this information. Please contact the Medical Practice by phone at (310) 734-4229 or email at assistant@drdmymd.com as well as at the Medical Practice site where you receive services to make a written request to not share PHI.

Required By Law: The Medical Practice may use or share your PHI if required by federal, state, or local law, or by court order or subpoena.

Public Health Activities: The Medical Practice may share your PHI with a public health authority in order to prevent or control disease, injury, or disability. 

Research: The Medical Practice may share health information for approved research projects. All research projects follow state and federal laws that protect patient privacy. All research projects that require sharing PHI must be approved through a special review process to protect patient safety, welfare, and confidentiality. If the special review process approves sharing health information for a research project, other studies may also use this same information. Researchers may contact patients to participate in certain research studies. Patients will only be contacted if the special review process has given their approval. You do not need to participate in any research project. If you agree to participate, you will need to sign an authorization form.

To Avert a Serious Threat to Health or Safety: The Medical Practice may use and share your PHI if we believe it is necessary to avoid abuse, neglect, or a serious threat to your health or safety or to someone else’s. We limit the information that is shared to that which is needed to respond to the emergency.

Deceased Individuals: The Medical Practice may use or share the PHI of a deceased individual after the individual has been deceased for 50 years.

WHEN WRITTEN PERMISSION IS NEEDED

If the Medical Practice needs to share your PHI for a reason not explained in this Notice, we will first need your written permission unless required by law. You may cancel your authorization in writing at any time. If you cancel your authorization, we will no longer use or disclose your PHI for the purposes covered by your written authorization. If you cancel your authorization, it will only effect new disclosures. You may contact the site that collected your authorization by phone at (310) 734-4229 or email at assistant@drdmymd.com to cancel the authorization.

WHAT ARE YOUR PRIVACY RIGHTS?

The following is a statement of your rights about your PHI and a brief description on how to exercise these rights.

You have the right to receive and review a copy of your PHI.

• You may receive and review a copy of your paper and electronic health records. Your health records include medical and billing records and any other records that we use for making medical decisions about your care.
• You have the right to receive your PHI in the format requested. If it is not available in that format, we will give it to you in another format.
• Please submit your requests to receive or review a copy of your PHI to the Medical Practice by email at assistant@drdmymd.com or at the Medical Practice site where you receive services.
• There may be a fee for providing you with your health records.
• Under some circumstances, your request to inspect or obtain a copy of your PHI may be denied. If your request is denied, you may request that the decision be reviewed.

You have the right to request a restriction on disclosures of your PHI.

• You may request that we limit our use of your PHI for treatment, payment, and health care operations purposes. We will review and consider your request.
• the Medical Practice does not have to agree to your request, unless it is to a health plan or insurer and you or someone on your behalf will be paying for all services out of pocket.
• To request a restriction or to revoke your authorization, you must make your request in writing to the Medical Practice via email at assistant@drdmymd.com. Your request must include what information you want to be restricted, whether you want to limit the use, disclosure, or both, whether you paid for services in-full, and/or to whom you want the limits to apply.
  

You have the right to request to receive confidential communications from us by alternative means or at an alternative location.

• You have the right to ask the Medical Practice to contact you only in writing at a different address or post office box, or by email or telephone.
• To request a change in how you receive confidential communications, send a written request to the Medical Practice and specify how you wish to receive confidential communications.

Shahrouz Sean Dadfarin MD, Inc. 

1134 South Robertson Blvd, Suite 2

Los Angeles, CA 90035. 

• The Medical Practice will accommodate all reasonable requests when necessary to protect your safety.

You have the right to request an amendment to your PHI.

• If you believe there is a mistake in your PHI or that important information is missing, you may request that we correct or add to the record.
• To request a change, send a written request to the Medical Practice via email at assistant@drdmymd.com. You must tell us what corrections or additions you are requesting, and why the corrections or additions should be made. We will respond in writing after reviewing your request.
• If we approve your request, we will make the correction or addition to your PHI. If we deny your request, we will tell you why and explain your right to file a written statement of disagreement.
• The Medical Practice cannot change records that were not created by the Medical Practice, are not part of your health record, or have been gathered for legal purposes.
• The Medical Practice cannot change information that is determined to be accurate and complete.

You have the right to receive a list of when your PHI was shared.

• You have the right to request a list of organizations and places we shared your PHI with.
• This list will include whom we shared the information with, when we shared the information, the reason the information was shared, and a description of the information shared.
• This list will not include when information was shared with you, shared with your permission, shared for treatment, payment, or health care operations, and other exceptions authorized by law.
• To request an accounting of disclosures, you must submit your request in writing to the Medical Practice via email at assistant@drdmymd.com. Your request must include a time-frame that is less than six-years old.
• You may receive one list every 12-months for no charge. If you require additional lists, there may be a fee.

the Medical Practice will inform you of this fee at the time you make your request.

You have the right to request a paper copy of this Notice of Privacy Practices.

• An electronic version of this Notice is on our website at https://drdmymd.com/. 
• For a paper copy of this Notice, you may contact the Medical Practice via email at assistant@drdmymd.com or the site where you received care.
  

HOW DO YOU CONTACT THE MEDICAL PRACTICE TO USE YOUR RIGHTS?

If you want to use any of the privacy rights explained in this Notice, you may contact the Medical Practice site from which you receive care or services. You may need to fill out a form to use your rights; if needed, we can help you fill out the form. Alternatively, you can call or write to us for assistance at:

Shahrouz Sean Dadfarin MD, Inc.
1134 South Robertson Blvd, Suite 2
Los Angeles, CA 90035
(310)734-4229
assistant@drdmymd.com  

HOW DO YOU CONTACT THE MEDICAL PRACTICE ABOUT YOUR PROTECTED HEALTH INFORMATION?

Shahrouz Sean Dadfarin MD, Inc.
1134 South Robertson Blvd, Suite 2
Los Angeles, CA 90035
(310)734-4229
assistant@drdmymd.com  

USE YOUR RIGHTS WITHOUT FEAR

We will not take retaliatory action against you if you file a complaint about our privacy practices.

COMPLAINTS/QUESTIONS

If you believe that we have not protected your privacy, you have the right to complain. You may file a complaint (or grievance) by calling or writing to us at the Medical Practice address below. If you have any questions about this Notice and want further information, please contact us at:

Shahrouz Sean Dadfarin MD, Inc.
1134 South Robertson Blvd, Suite 2
Los Angeles, CA 90035
(310)734-4229
assistant@drdmymd.com  

Or, you may contact:

U.S. Department of Health and Human Services
Office for Civil Rights – Pacific Region
90 7th Street, Suite 4-100
San Francisco, CA 94103
Toll-Free Center: (800) 368-1019
Fax: (202) 619-3818
TDD: (800) 537-7697
Email: ocrmail@hhs.gov 

www.hhs.gov/ocr/privacy/hipaa/complaints/

 

SMS/Text Messaging Privacy Policy

SMS opt-in or phone numbers for the purpose of SMS are not shared with any third parties or affiliate companies for marketing purposes.

Overview

The Office of Dr. Shahrouz Sean Dadfarin, MD and our privacy statement recognizes the value of privacy of the university community members and its guests.

This privacy notice provides more specific information on how the Office of Dr. Dadfarin text messaging service collects and processes your personal information.

Scope

The notice applies to our practices for gathering and disseminating information related to the Office of Dr. Dadfarin’s text messaging service (“we”, “us”, or “our”) and is meant to provide you an overview of our practices when collecting and processing personal information.

How We Collect Information

We collect personal information in the following circumstances:

• Direct Collection, when you provide information by responding to text messages.

What Type of Information We Collect

Direct Collection

We directly collect the following personal information:

• Opt-out preferences
• Content of your text message responses to us.

Collection from Medical Records

We import personal information from our medical systems and sources. The information includes:

• First and last name
• Phone number.

Automated Collection

We automatically collect the following personal information:

• Device status indicating whether a device is available for messaging
• Carrier (e.g. Verizon, AT&T, etc.)
• Country associated with the phone (we are not sending international text messages)
• Delivery status
• Error codes indicating why a message was not delivered (e.g. number associated with a landline, unreachable device, etc.)

How This Information Is Used

We use the personal  information we collect to communicate with you regarding your upcoming appoinments and services with The Office of Dr. Dadfarin, such as:

• Appointment reminders and clarifications regarding parking/navigating the office location, to ensure a smooth appointment.
• Updates, to keep you informed of important dates or activities specific to your relationship with Dr. Dadfarin’s medical office.

With Whom This Information Is Shared

We do not sell or rent your personal information. Furthermore, due to Health Insurance Portability and Accountability Act (HIPAA), as a patient of Dr. Dadfarin, your health information is kept private and confidential.

We require our service providers to keep your personal information secure, and do not allow them to use or share your personal information for any purpose other than providing services on our behalf.

What Choices You Can Make About Your Information

If you wish to unsubscribe from text messages for a campaign, you can reply with words, such as ‘cancel’, ‘end’, ‘quit’, ‘unsubscribe’, ‘stop’, or ‘stop all’ and you will no longer receive messages.

If you wish to re-subscribe, reply with words, such as ‘start’, ‘yes’, or ‘unstop’.

Please note that unsubscribing from text messages from one campaign will not unsubscribe you from other campaigns. Unsubscribing will not remove your information from sourced appointment reminder texts, you will need to unsubscribe from that separately.

The accuracy of your contact information in The Office of Dr. Dadfarin’s system is critical for the delivery of text messages. If you wish to update your contact information, please contact the office at 310-598-1529.

How Information Is Secured

The Office of Dr. Dadfarin recognizes the importance of maintaining the security of the information it collects and maintains, and we endeavor to protect information from unauthorized access and damage. The Office of Dr. Dadfarin strives to ensure reasonable security measures are in place, including physical, administrative, and technical safeguards to protect your personal information.

Privacy Notice Changes

This privacy notice may be updated from time to time. We will post the date our notice was last updated at the top of this privacy notice.

Who to Contact With Questions or Concerns

If you have any concerns or questions about how your personal data is used, please contact the Office of Dr. Dadfarin at 310-598-1529 or write to us at The Office of Shahrouz Sean Dadfarin, MD at 1134 S Robertson Blvd Suite 2, Los Angeles, CA 90035

Consent for SMS Communication

 

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