NOTICE of PRIVACY PRACTICES
EFFECTIVE: APRIL 14, 2003

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

OUR RESPONSIBILITIES
Our office takes the privacy of your health information seriously. We are required by law to maintain that privacy and to provide you with this Notice of Privacy Practices. This Notice tells you about our duties and practices regarding your information. We are required to abide by the terms of this Notice that are currently in effect. We reserve the right to revise this Notice.

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
The following categories describe different ways that we may use and disclose your health information. For each category. an explanation and some examples are given. Not every use or disclosure in a category will be listed. However, the ways we are permitted to use and disclose information will fall within one of the categories.

OTHER USES OF HEALTH INFORMATION
Other uses and disclosures of health information not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you provide us authorization to use or disclose your health information, you may revoke or withdraw that authorization, in writing, at any time. If you revoke that authorization, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made under the authorization, and that we are required to retain our records of the care that we provided you.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

CHANGES TO THIS NOTICE
We reserve the right to change this Notice. We reserve the right to make the revised Notice effective for health information we already have about you as well as any information we receive in the future. We will give you a copy of this Notice on your first encounter with this office that occurs on or after April 14, 2003.

COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with our office or with the Department of Health and Human Services. To file a complaint with our office, contact our Office Manager at 703.671.7240. All complaints must be submitted in writing. The health care services provided to you by this office will not be affected in any way for filing a complaint.