Model patient privacy protection statement

You have the right to privacy as a patient.

You will receive treatment considerate and respectful of your personal values and beliefs, without regard to national origin, citizenship, country of residence, language, race, color, religion, ancestry, medical diagnosis, mental or physical disability, genetic makeup, educational background, gender, sexual orientation, marital status, economic status, or the source of payment for your care.

You will receive evaluation and treatment in confidence and privacy, including in all written and electronic records, during case discussion, consultation, examination and treatment except where reporting is required by law.

You will receive evaluation and treatment in facilities that ensure privacy during personal care, examinations and treatment; and interventions carried out only in the presence of those persons necessary for the intervention unless you agree.

You may designate an “alias” name by which to be known.

We do not collect any personal information about you through this website without your explicit permission. We do not sell, rent, or loan any identifiable information regarding website visitors to any third party. Any information you give us is held with the utmost care and will not be used in ways for which you have not consented.

When you register for any services with [COMPANY NAME], we may place you on our list to receive e-mail regarding updates about new services. If you do not wish to receive e-mail updates in the future, you can remove yourself by following the instructions at the bottom of any direct e-mail you receive from us.