Pine Grove Behavioral Health and Addiction Services

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Pine Grove Behavioral Health and Addiction Services

FORREST GENERAL HOSPITAL
NOTICE OF PRIVACY PRACTICES

Privacy Policy Document (PDF)

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 General Hospital 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 General Hospital is required by law to abide by the terms of 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 General 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

We may disclose your medical information in the course of certain judicial or administrative proceedings.

Law Enforcement

We may disclose your medical information for law enforcement purposes or to law enforcement officials under certain circumstances. 

Coroners, Medical Examiners and Funeral Directors

Organ Donation

Research

Public Safety

Specialized Governmental Functions

Workers' Compensation

We may disclose your medical information as authorized by laws relating to workers’ compensation or similar programs.

Business Associates

We may disclose your medical information to a business associate with whom we contract to provide services on our behalf. To protect your medical information, we require our business associates to appropriately safeguard the medical information of our patients.

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 General Hospital has taken an action in reliance on the use or disclosure as indicated in the authorization. To request a Revocation of Authorization form, you may contact:

Forrest General Hospital, Health Information Management Department
P.O. Box 16389
Hattiesburg, MS, 39404
601-288-2900.

Your rights regarding your medical information

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

THIS NOTICE IS EFFECTIVE AS OF JULY 1, 2001.

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 General Hospital and will make paper copies of the revised Notice of Privacy Practices available upon request.

Psychology Internship Program

Pine Grove has an excellent internship program that offers a wide range of training activities in our three rotations. We are able to offer interns opportunities for training in residential and outpatient settings working with adults, adolescents, and children. We are APA accredited as a single entity pre-doctoral psychology internship program under the name of Pine Grove Behavioral Health & Addiction Services, Doctoral Internship in Professional Psychology (PG-DIPP).

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