Pine Grove Behavioral Health and Addiction Services

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Pine Grove Behavioral Health and Addiction Services

Forrest Health System Notice of Privacy Practices

Privacy Policy Document (PDF)

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU MAY GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Forrest Health System is dedicated to protecting your medical information. We are required by law to maintain the privacy of your medical information and to provide you with this notice of our legal duties and privacy practices with respect to your medical information. Forrest Health System is required by law to abide by the terms of this notice. Please visit our website at http://www.forresthealth.org for a list of the facilities operated by Forrest Health and bound by this Notice.

HOW YOUR MEDICAL INFORMATION WILL BE USED AND DISCLOSED:

We will use and disclose your medical information as part of rendering patient care for treatment, payment or health care operations purposes. For example, your medical information may be used by the doctor or nurse treating you, by the business office to process your payment for the services rendered and by administrative personnel reviewing the quality of the care you receive. We may and often do make your records available to medical personnel at other facilities who are providing care and treatment to you, so that they will be aware of your complete medical history as reflected in our medical records system. For example, the Hattiesburg Clinic shares our medical record system and has access to your Forrest Health System records when you are a patient of that clinic.

Much of your health information is stored electronically, rather than being in paper form. When we use or disclose your protected health information in the ways described in this notice, we may do so by providing printed copies of your health information or by allowing the authorized person or persons to access the electronic record. However, whether your health information is in paper or electronic form, we will handle it in compliance with the provisions of this notice.

We may also use and/or disclose your medical information in accordance with federal and state laws for the following purposes:

Appointment Reminders:

Treatment Information:

Fund Raising:

Disclosure to Department of Health and Human Services:

Facility Directory:

Family and Friends:

Notification:

Disaster Relief:

Public Health Activities:

Health Oversight Activities:

Abuse or Neglect:

Legal Proceedings:

Law Enforcement:

Coroners, Medical Examiners and Funeral Directors:

Organ Donation:

Research:

Public Safety:

Specialized Governmental Functions:

Workers’ Compensation:

Business Associates:

AUTHORIZATIONS:

We must have your authorization for any use or disclosure of your PHI involving certain mental health records (including psychotherapy notes), marketing activities, or sale of your information. We will not use or disclose your medical information for any other purpose without your written authorization except as otherwise permitted or required by law. Once given, you may revoke your authorization in writing at any time except to the extent that Forrest Health System has taken an action in reliance on the use or disclosure as indicated in the authorization. Revocation of any authorization must be made in writing and sent to Forrest Health System, Health Information Management Department, P.O. Box 16389, Hattiesburg, MS, 39404.

YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION:

You have the following rights with respect to your medical information:

REVISION OF NOTICE OF PRIVACY PRACTICES:

We reserve the right to change the terms of this notice, making any revision applicable to all the protected health information we maintain. If we revise the terms of this notice, we will post a revised notice at Forrest Health System and will make paper copies of the revised Notice of Privacy Practices available upon request.

Revised September 25, 2015.

Psychology Internship Program

Pine Grove has an excellent internship program that offers a wide range of training activities on two rotations. We are able to offer interns opportunities for training in residential, partial hospitalization, and outpatient settings working with adults presenting with a ride range of diagnoses. We are APA accredited as a single entity doctoral psychology internship program under the name of Pine Grove Behavioral Health & Addiction Services, Doctoral Internship in Professional Psychology (PG-DIPP). Please visit our Psychology Internship Program home page for more information.

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