In accordance with The Center’s HIPAA Privacy Notice and applicable law, The Center takes reasonable precautions to protect the confidentiality of personally identifiable information of users to our Web site, such as a name and phone number that a user may provide for an appointment call back. If you have questions about our privacy notice, please contact the following: Chief Privacy Officer, Polo Ralph Lauren; 625 Madison Avenue, 11th Floor; New York, NY 10022.
This HIPAA Privacy Notice applies to all of the records of the care and services you receive at The Center, whether made by staff or your physician. This Policy will tell you about the ways in which we may use and disclose medical information about you. This Policy also describes your rights and certain obligations we have regarding the use and disclosure of your medical information.
Personal Information Submitted By Users
We do not obtain personal information (e.g. name, address, e-mail address, health information, etc.) about you when you visit The Center’s Web site unless you choose voluntarily to provide any such information to us.
If you provide any such personal information by sending an e-mail or otherwise, there are a few things you should know.
• Various people at The Center may see the personal information you submit.
• We may enter the personal information you send into our electronic database and/or share such information with our physicians, other health care professionals, researchers, or our Internet services staff as necessary for treatment or health care operations, provided that such entities have agreed to treat such information as confidential.
• We may use or disclose your medical information for public health activities, including the reporting of disease, injury, vital events and the conduct of public health surveillance, investigation and/or intervention. We may disclose your medical information to a health oversight agency for oversight activities authorized by law, including audits, investigations, inspections, licensure or disciplinary actions, administrative and/or legal proceedings.
• We may share your information in other limited circumstances, where we receive requests from health care agencies, legal authorities or are otherwise as required by law or to prevent or lessen a serious threat to the health or safety of another person or to the public.
Other uses or disclosures of your medical information for other purposes or activities, not listed above, will be made only with your written authorization (permission). If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written permission. However, we are unable to withdraw any disclosures we have already made with your permission.
You should note that electronic mail and other Internet communications channels are not necessarily secure against interception. While we take reasonable precautions where appropriate, if your communication is very sensitive, or includes information such as your diagnosis or medical history, you might want to send it by postal mail instead.
Aggregate Information is non-personally identifiable/anonymous information about you, such as types of information sought, pages you access most frequently or search terms you enter (if applicable). Aggregate Information is used in a collective manner, and no single person can be identified by that compiled information. Tracking Internet Protocol (IP) addresses is one method of collecting Aggregate Information about your activities online and information volunteered by you. An IP address is a number that is automatically assigned to your computer whenever you surf the Web. The computers, which deliver the Web pages to you, automatically identify your computer by its IP address. When you request a page from our Web site, our servers may log your IP address.
Our web server may collect and store the following general information about you:
• the name of the domain from which you access the Internet (for example, aol.com, if you are connecting from an America Online account);
• the date and time you access our service;
• the pages you visit;
• the Internet address of the web site from which you linked directly to us; and
• the name and release number of web browser software you are using.
This information is collected automatically and is not linked to your personal identity. It is used in an aggregate way to help us improve our Web site and make it more useful to you.
Right to Request Restrictions
You have the right to request a restriction or limitation on the medical information we use or disclose about you. We will attempt to accommodate all reasonable requests, but in certain circumstances we may not be able to comply. To request restrictions, you must make your request in writing to email@example.com or Chief Privacy Officer, The Ralph Lauren Center for Cancer Care and Prevention, 1919 Madison Avenue New York, NY 10035. In your request, you must tell us: (1) what information you want to limit; (2) whether you want to limit our use or disclosure of the information (or both); and (3) to whom you want the limits to apply.
Right to Request Alternate Communication Methods
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you by telephone at work or that we only contact you by mail at home. To request such a limitation, you must make your request in writing to firstname.lastname@example.org or Chief Privacy Officer, The Ralph Lauren Center for Cancer Care and Prevention, 1919 Madison Avenue New York, NY 10035. We will not ask you the reason for your request. We will attempt to accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to Inspect and Copy
You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records and excludes psychotherapy notes, if applicable. To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to email@example.com or Chief Privacy Officer, The Ralph Lauren Center for Cancer Care and Prevention, 1919 Madison Avenue New York, NY. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by The Ralph Lauren Center for Cancer Care and Prevention will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
Right to Amend
If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for The Ralph Lauren Center for Cancer Care and Prevention. To request an amendment, your request must be made in writing and submitted to firstname.lastname@example.org or Chief Privacy Officer, The Ralph Lauren Center for Cancer Care and Prevention, 1919 Madison Avenue New York, NY 10035. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: (1) was not created by us, unless the person or entity that created the information is no longer available to make the amendment; (2) is not part of the medical information kept by or for The Ralph Lauren Center for Cancer Care and Prevention; (3) is not part of the information that you would be permitted to inspect and copy; or (4) is accurate and complete.
Right to an Accounting of Disclosures
You have the right to request an "accounting of disclosures" by The Ralph Lauren Center for Cancer Care and Prevention of your medical information that occurred in the past six (6) years. The accounting (or list) of disclosures will include: (1) the date of the disclosure; (2) the name of the entity or person who received the medical information and, if known, the address; (3) a brief description of the medical information disclosed; and (4) a brief statement of the purpose of the disclosure. To request this list, you must submit your request in writing to email@example.com or Chief Privacy Officer, The Ralph Lauren Center for Cancer Care and Prevention, 1919 Madison Avenue New York, NY 10035. Your request must state a time period that may not be longer than six (6) years. The first list you request within a twelve (12) month period will be free of charge. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to a Paper Copy of This Policy
You have the right to a paper copy of this Policy. You may ask us to give you a copy of this Policy at any time. Even if you have agreed to receive this Policy electronically, you are still entitled to a paper copy of this Policy. To obtain a paper copy of this Policy, contact firstname.lastname@example.org or Chief Privacy Officer, The Ralph Lauren Center for Cancer Care and Prevention, 1919 Madison Avenue New York, NY 10035.
Corrections To Personal Information Collected Online
You can ask us by mail for a summary of any personal information that Polo.com has retained about you. In addition, if you believe that your privacy rights have been violated, or if you wish to change, correct, delete or update your personal information at any time. please address any complaints or requests to email@example.com or Chief Privacy Officer, The Ralph Lauren Center for Cancer Care and Prevention, 1919 Madison Avenue New York, NY 10035. Please be sure to include your email address, full name and postal address.
Acceptance of Terms
By using the Polo.com Web site, you signify your acceptance of our Privacy Notice. By providing Personal Information to us through The Center’s Web site, you signify your acceptance of our Privacy Notice with respect to the collection and use of personal information. If you do not agree to this Privacy Notice, please do not use the Center’s Web site. Your continued use of the Web site following the posting of changes to these terms will mean that you accept these changes accordingly.