By clicking "I Agree," I certify that I’ve read and understand this Notice and accept its use regarding my confidential health information.I Agree to the Privacy Notice
I Do Not Agree to the Privacy Notice
Please review this notice carefully and press “I agree” to move on to the On-line Intake survey and MommyTrax online health resources.
Before accessing services please take a moment a review this information. It describes how health information about you may be used and disclosed and how you can get access to this information.
MommyTrax Privacy Notice
You must be 18 years old or older to access MommyTrax consultation services. MommyTrax consultation services offered online are supportive and educational and are intended to assist you in exploring actions to improve your health. They are not intended in any way to replace medical or counseling services related to more serious health concerns and the treatment of illness. If you are experiencing serious medical, behavioral or emotional problems, please contact a physician or behavioral health therapist for assistance.
While we use the latest tools of technology to establish and maintain the confidentiality of information exchanged through online services, no system is 100% secure. Please contact RBH at 1-800-441-0445 for details.
Use and Disclosure of Your Health Information
Your health information may include information created and received by our staff, may be in the form of written or electronic records or spoken words, and may include information about your work-life issues, health status, treatments, procedures and similar types of health-related information.
If you choose to participate in MommyTrax services, the information you share with us about your work-life status will be used by our consultants in their communications with you and with our staff in planning how to improve our services.
In addition, we may use and disclose information for the following purposes:
- For Treatment: We may use health information about you to assist in the provision to you of clinical treatment or services. We may disclose health information about you to doctors, practitioners and facilities and their office staff or other personnel who are involved in taking care of you and your health. For example, we may be involved in referring you to a health care provider, or we could be sharing information about your health status and who is providing care to you in order to facilitate the coordination of care.
- Treatment Alternatives/Health-Related Products and Services: We may tell you about or recommend possible treatment options or alternatives that may be of interest to you. We may tell you about health-related products or services that may be of interest to you.
- Substance Abuse Treatment: Federal law requires your written consent each time we release health information related to substance abuse treatment. The Consent will specify who is to receive the information, the purpose of the release of information, and a time period after which the Consent will terminate. You may modify or revoke a Consent at any time. However, if you choose to revoke a Consent, we may be unable to effectively complete our activities related to treatment, payment or health care operations.
We may use or disclose health information about you for the following purposes, subject to all applicable legal requirements and limitations. If you have questions with regard to any of these exceptions to protecting your health information, consult with your attorney prior to disclosing confidential information online.
- 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.
- Required By Law: We will disclose health information about you when required to do so by federal, state or local law. We may also disclose health information about you in response to a valid subpoena, court order, warrant, summons or similar process.
- Military, Veterans, National Security and Intelligence: If you are or were a member of the armed forces, or part of the national security or intelligence communities, we may be required by military command or other government authorities to release health information about you. We may also release information about foreign military personnel to the appropriate foreign military authority.
- Workers’ Compensation: We may release health information about you for workers’ compensation or similar programs, depending upon the legal status of a given program. These programs provide benefits for work-related injuries or illness.
- Public Health Risk: We may disclose health information about you for public health reasons in order to prevent or control disease, injury or disability; or report births, deaths, suspected abuse or neglect, non-accidental physical injuries, reactions to medications or problems with products.
- Health Oversight Activities: We may disclose health information to a health oversight agency for audits, investigations, inspections, or licensing purposes. These disclosures may be necessary for certain state and federal agencies to monitor the health care system, government programs, and compliance with civil rights laws.
- Information Not Personally Identifiable: We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.
Other Uses and Disclosures of Health Information
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. 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, but we cannot take back any uses or disclosures already made with your permission.
Your Rights Regarding Health Information About You
You have the following rights regarding health information we maintain about you:
- Right to Inspect and Receive a Copy: You have the right to inspect and request a copy of your health information. Most often you’ll have immediate access to your information online, but should you wish a hardcopy of your information, please contact our Privacy Officer.
- Right to Amend: If you believe health 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 as long as the information is kept by this office. To request an amendment, ask for a copy of RECORD AMENDMENT/CORRECTION FORM from our Privacy Officer.
- Right to Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had. To request restrictions, ask for a copy of REQUEST FOR RESTRICTION ON USE/DISCLOSURE OF HEALTH INFORMATION from our Privacy Officer.
- Right to Request Confidential Communications: You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, ask for a copy of REQUEST FOR RESTRICTION ON USE/DISCLOSURE OF HEALTH INFORMATION from our Privacy Officer.
If you have any questions about this notice, please contact our Privacy Officer at 1-866-750-1327
By clicking "I agree," I certify that I’ve read and understand the above Notice and accept its use regarding my confidential health information.I Agree to the Privacy Notice
I Do Not Agree to the Privacy Notice