HIPAA (Health Insurance Portability and Accountability Act of 1996)

Disclosure of Protected Health Information


The privacy of your medical history and information is important to us. We understand that your medical information is personal and we are committed to protecting it. We create a record of the care and services that you receive at our office. We need this record to provide you with quality care and to comply with certain legal requirements. This notice will tell you about the ways we will use and share your information.

HIPAA ensures the privacy and security of individual health information. The office of Dr. Brett Coapland and its direct assigns, will use your personal information solely for the purpose of obtaining appropriate medical history, diagnosis, treatment, settlement of claims, and billing for services provided by this office.

The Law requires us to:

  • Keep your medical information private.
  • Make available to you this notice regarding your rights with regards to your medical information.
  • Follow the laws with respect to HIPPA that are now in effect.

Should another physician, attorney or insurance company request information on your behalf, we will refuse such information until an authorization to release records is received from you.

As a patient, you understand, agree and comply with our privacy policy with regards to Federal Privacy Regulations. You have the right to a file a complaint and receive a copy of that complaint should you feel any of your privacy rights have been violated. Should a privacy complaint be filed, you will not be required to give up or rescind your status as a patient at this office per Federal Privacy Act Guidelines.

If at any time a patient refuses to give the necessary information as stated above, he/she may be refused as a patient.


  • Contact Us

    91A N. State Street
    Concord, NH 03301
    P: (603) 724-2297
    F: (603) 369-3017

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