1410 Oak Street, Ste 200, Eugene, OR 97401 • (877) 852-7246
We are following the latest guidelines issued by the Centers for Disease Control and Prevention (CDC) for screening, testing and infection control, and our entire team meets daily to prepare for all aspects of operations from supply procurement to caring for new patients. Additionally, KeiperSpine and the Spine Surgery Center of Eugene has created stringent protocols to keep patients and staff safe [Read COVID19 Statement]
This notice describes how medical information about you may be used and disclosed and how you have access to this information. Please review it carefully.
If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. To file a complaint with our offices, contact:
Our Office at:
Tony Ballenger RN, BSN, MBA
Administrator-Spine Surgery Center of Eugene
1410 Oak Street Ste 200, Eugene OR 97401
You will not be penalized for filing a complaint.
We take our responsibility to safeguard your protected health information very seriously. We value your trust as an important part of our ability to provide you with the best possible medical care. We are dedicated to defending your right to a confidential relationship with your physician.
This notice is intended to inform you of how we protect, use and disclose your information, as well as to explain your right to control these disclosures.
To Avert a Serious Threat to Health or Safety... We may use and disclose health information about you without your permission for the following purposes.
Required by Law... We may disclose your information for treatment purposes and to coordinate your medical care.
Research... We may disclose your information to ensure that you receive insurance benefits.
Organ and Tissue Donation... We may disclose your information internally to enhance the operation of our practice. This includes our commitment to reviewing the quality of care we provide.
Military, Veterans, National Security and Intelligence... We may disclose your information to comply with a limited number of legal requirements, as outlined in this notice.
Workers' Compensation... Additional information regarding each of these disclosures is provided in this notice. In any case, we will only disclose the minimum amount of information necessary for the purpose it was requested.
We may use or disclose health information about you without your permission for the following purposes, subject to all applicable legal requirements and limitations: To Avert a Serious Threat to Health or Safety. We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
For example, we may assume you agree to our disclosure of your personal health information to your spouse when you bring you spouse with you into the exam room during treatment or while treatment is discussed. In situations where you are not capable of giving consent (because you are not present or due to your incapacity or medical emergency), we may, using our professional judgment, determine that a disclosure to your family member or friend is in your best interest. In that situation, we will disclose only health information relevant to the person’s involvement in your case. We may also use our professional judgment and experience to make reasonable inferences that it is in your best interest to allow another person to act on your behalf to pick up, for example, filled prescriptions, medical supplies, or X-rays.
We will not use or disclose your health information for any purpose other than those identified in the previous sections without your specific, written Authorization. We must obtain your Authorization separate from any Consent we may have obtained from you.
If you give us Authorization to use or disclose health information about you, you may revoke that Authorization, in writing, at any time.
If you revoke your Authorization, we will no longer use or disclose information about you for the reasons covered by your written Authorization. However, we cannot take back any uses or disclosures already made with your permission.