NOTICE AND AUTHORIZATION REQUIRED FOR ELECTRONIC DISCLOSURE OF PROTECTED HEALTH INFORMATION *
Please be advised that Connatser Family Law receives, maintains, and in some instances discloses protected health information (PHI) of individuals in electronic format. All electronic health records maintained by this office are subject to electronic disclosure.
PHI may include information that relates to:
- Your past, present, or future physical or mental health or condition;
- Healthcare provided to you; and
- Past, present, or future payment for your healthcare.
This office cares about the privacy of your PHI. If we obtain or create information about your health, we protect the privacy of your information as required by law. To the extent your PHI is disclosed electronically by Connatser Family Law, this document serves to provide you notice of such disclosure. This is in compliance with requirements of the Texas Health and Safety Code, Section 181.154. Connatser Family Law will secure a separate authorization from you or a legally authorized representative. Furthermore, we will do this prior to electronically disclosing PHI. We do this for any reason other than treatment, payment, healthcare operations, or as required by state or federal law.
*We provide this notice pursuant to federal law and Section 181.154 of the Texas Health and Safety Code.