PRIVACY NOTICE

This privacy notice describes how your medical information
may be disclosed and used by this practice. This notice also discusses your
rights to access your medical information. The HIPAA Privacy Rule allows your
health information to be disclosed to carry out treatment, payment, and other
healthcare operations. We are required to abide by the information outlined in
this privacy notice. We reserve the right to update this policy as changes
occur in the HIPAA Privacy Rule. HIPAA grants you the right to access and
control your health information.

USES AND
DISCLOSURES

Treatment: Your health information will be disclosed
to provide, coordinate, and manage your healthcare. All of the providers in our
practice may have access to your medical records. Additionally, our medical
consultants and ultrasonographer review some records to assist us with your
care. Your health information may be disclosed to any other physician or
healthcare provider that may become involved in your care.

Healthcare Operations: Your health information will be
used to support the business activities of the practice. Examples include, but
are not limited to: quality assessment, employee reviews, nursing and midwifery
student training, licensing, and other business activities. Health information
may be shared in our group prenatal sessions.

Payment: Your health information will be used to
obtain payment for services provided by this practice. Disclosures may be given
to health plans, insurance providers, and collection agencies.

Business Associates: Your health information may be
shared with third party business associates. Examples include billing and legal
services. We have established written contracts that contain the terms that
will protect your health information with all third-party business associates. All
business associates must comply with HIPAA guidelines.

Disclosures Requires by Law and Workers Compensation: We are
permitted to disclose your health information to comply with workers
compensation laws and legal proceedings. If required, you will be notified of
disclosure. The protected health information of members of the armed forces may
be disclosed to authorized federal officials, under certain circumstances.

Abuse or Neglect: We may disclose your protected
health information to the appropriate authorities if we reasonably believe that
you are a possible victim of abuse, neglect, or domestic violence.

Emergencies: If you are incapacitated, we may use our
best judgement to disclose information that is only directly relevant to your
care.

Research and Health Oversight: We are permitted to
disclose your information to researchers with an institutional review board has
reviewed a research proposal and established protocols to ensure your health
information will be kept confidential. We are permitted to disclose your health
information to a health oversight agency for activities authorized by law.
Examples include: audits, investigations, and inspections.

Written Authorization: Unless not required by law,
your written authorization will be required for all disclosures of your
protected health information. You can revoke authorization at any time via
written request. It is important to note that we are unable to undo any
disclosures previously made with your authorization.

Voicemail: Employees may only leave detailed
voicemail messages if the greeting appropriately identifies the patient or
another person who is authorized to receive information regarding the patient.
If there is not appropriate identification, only the minimum necessary
information will be left. This includes the caller’s name, practice name, and a
contact number. Patients have the right to opt out of voicemail messages.

PATIENT RIGHTS

You have the right to inspect and copy your protected health
information. You may obtain your medical record that contains medical and
billing information. As permitted by federal or state law, we may charge you a
reasonable copy fee to provide a copy of your records. You may request an
amendment of your protected health information. We reserve the right to deny your
request. If we deny your request for amendment, you have the right to file a
statement of disagreement. We may provide you with a copy of any rebuttal.
Federal law prohibits you from inspecting or copying psychotherapy notes and
information compiled in reasonable anticipation of, or use of, civil or
criminal proceedings, or administrative actions or proceedings.

PRIVACY
COMPLAINTS/ CLIENT GRIEVANCES

Should you believe that your privacy rights have been
violated, and wish to file a complaint, you may contact us by calling our
office at (912)629- 6262 and asking to speak with our privacy officer. The
director or her designee will personally respond within 10 business days to any
complaint registered by a client about any aspect of Family Health and Birth Center.
You may also contact our accrediting organization, The Commission for the
Accreditation of Birth Centers at 240 Independence Drive, Hamburg, PA 19526,
phone number 1-877-241-0262. Unresolved complaints may be directed to the
Georgia Department of Community Health, Health Facilities Regulation Division,
Attention: Complaints, 2 Peachtree Street NW, Atlanta, GA 30303-3142, phone:
1-800-878-6442.