THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GETACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
WHO WILL FOLLOW THIS NOTICE: We may use your medical information, also known as protected health information (“PHI”), for treatment, payment, Laboratory operations, research or fundraising purposes as described in this notice. All employees of Bio-Genetics Laboratory follow these privacy practices. The laboratory directors, technicians, and other laboratory staff will also follow this notice when they work at the Laboratory.
ABOUT THIS NOTICE: This notice will tell you about the ways we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information. We are required by law to:
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU: The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures, we will explain what we mean and give examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one or more of the categories.
o The patient consents in writing:
o The disclosure is allowed by a court order; or
o The disclosure is made to medical personnel in a medical emergency or to
qualified personnel for research, audit, or program evaluation.
o to a person subject to the jurisdiction of the Food and Drug Administration
(FDA) for purposes related to the quality, safety or effectiveness of an
FDA-regulated product or service;
o to prevent or control disease, injury or disability;
o to report disease or injury;
o to report births and deaths;
o to report child abuse or neglect;
o to report reactions to medications and food or problems with products;
o to notify people of recalls or replacements of products they may be using;
o to notify a person who may have been exposed to a disease or may be at risk for
contracting or spreading a disease or condition;
o to notify the appropriate government authority if we believe a patient has been the
victim of abuse, neglect or domestic violence. We will only make this disclosure
if you agree or when required or authorized by law.
o in response to a court order, subpoena, warrant, summons or similar process;
o to identify or locate a suspect, fugitive, material witness or missing person;
o about the victim of a crime if, under certain circumstances, we are unable to obtain
the person's agreement;
o about a death we believe may be the result of criminal conduct;
o about criminal conduct at the Laboratory or by healthcare providers affiliated with
the Laboratory;
o in emergency circumstances to report a crime, the location of the crime or victims, or
the identity, description or location of the person who committed the crime; and
o to authorized federal officials so they may provide protection for the President and
other authorized persons or conduct special investigations.
o The protected health information that is disclosed is limited to proof of immunization;
o The school is required by State or other law to have such proof of immunization prior
to admitting the individual; and
o The covered entity obtains and documents the agreement to the disclosure from
either:
o A parent, guardian, or other person acting in loco parentis of the individual, if the
individual is an un- emancipated minor; or
o The individual, if the individual is an adult or emancipated minor.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU: You have the following rights regarding medical information we maintain about you:
BIOGX LABORATORY (“Laboratory”) is required by law to protect the privacy of your health information, and to provide you with a copy of this notice, which describes the health information privacy practices of our Laboratory, its personnel, and affiliated providers that jointly perform payment activities and business operations with our Laboratory. "Protected Health Information" is information about you, including demographic and genetic information, that may identify or be used to identify you, and is information which relates to your past, present or future physical or mental health or condition, the provision of related health care services, or payment for health care services. This Acknowledgement Form will become part of your permanent medical record.
FOR MORE INFORMATION PLEASE CONTACT THE PRIVACY OFFICER:
Roy Eliasson
BIO-Genetics Laboratory
805 Executive Center Dr. W suite 100
St Petersburg, FL 33702
Phone contact may occur from any of our following registered phone numbers:
201-201-1488
202-235-2312
202-991-8882
203-208-7138
205-203-0918
207-200-9557
207-770-1444
208-609-4003
208-609-4004
209-200-4967
209-336-0006
210-202-4621
213-302-8940
213-306-6565
214-225-0766
215-258-4478
216-455-7090
216-770-8898
217-803-1051
218-325-3498
218-558-0853
219-261-6909
219-661-7969
220-201-5168
223-227-4259
223-227-5187
224-285-0002
224-704-1254
225-283-6566
225-398-0364
228-202-5585
228-831-7180
229-466-0998
231-335-4620
231-338-6897
234-208-7774
234-757-7154
239-628-3782
240-324-7220
240-844-1933
248-206-0065
251-299-4328
251-299-4440
252-389-9754
252-594-8874
253-240-0144
254-221-6135
254-540-9677
256-414-2370
256-768-5088
260-252-1503
260-786-0816
262-342-6052
262-706-5552
267-227-1804
267-603-7878
269-290-1953
269-729-6378
270-216-0032
272-252-0250
272-999-6283
276-383-0477
276-477-4043
279-202-0464
279-356-1609
281-417-8607
281-817-6058
301-750-6581
301-969-8169
302-648-4987
302-669-9329
304-504-2377
304-853-6700
305-705-5196
305-902-3605
307-381-1715
307-620-8918
308-409-0178
308-940-5130
309-245-1446
309-605-0863
310-810-0045
312-682-9509
313-548-1407
313-644-2534
314-461-9428
314-530-6640
315-359-9048
315-659-4721
316-477-3053
316-500-3527
317-343-4992
318-233-1108
318-616-3099
319-359-7366
319-462-8622
320-391-6495
320-406-1035
321-200-0755
321-477-1941
323-409-0092
323-892-5393
325-241-9105
325-400-0531
330-800-5589
330-800-5743
331-425-8836
331-808-0397
332-246-0988
334-463-5179
334-482-6334
336-296-1240
336-645-6357
337-245-0009
337-915-0955
339-203-6987
346-789-0408
347-896-0471
351-203-0355
352-282-0287
352-670-9823
360-227-1979
361-214-1746
361-747-6560
364-202-6374
380-300-6065
380-888-6027
385-381-4877
385-758-4393
386-299-9257
386-800-1957
401-423-5997
401-859-4631
402-512-0846
402-736-0656
405-289-9941
405-648-0767
406-564-1863
406-813-2134
407-434-9182
407-584-7524
408-214-5315
409-231-0195
409-710-2513
410-231-3966
412-517-6008
412-945-7202
413-341-6224
413-461-9072
414-644-5705
414-644-5974
415-226-6890
417-695-4605
417-695-5415
419-396-5957
419-737-4004
423-397-5651
423-567-8705
424-205-5009
424-430-3384
425-270-8699
430-266-8919
430-342-1190
432-244-3788
432-538-1749
434-299-2197
434-381-1130
435-258-7989
435-994-8481
440-586-8422
440-673-3489
442-204-0097
442-312-8368
443-837-7610
443-860-0773
445-465-9380
445-895-1528
458-203-0029
458-246-8648
463-235-7804
463-600-9107
469-589-1763
469-780-2401
470-306-0505
470-763-4220
475-284-0884
475-284-0893
478-200-2376
478-300-7457
479-343-1626
479-579-9827
480-210-9910
480-999-3662
484-514-9038
484-820-4314
501-434-1888
501-530-4282
502-324-3213
502-849-3799
504-350-0225
504-619-8689
505-219-1075
507-323-2729
507-401-4633
508-492-3803
509-289-5786
510-831-2148
510-961-1366
513-828-0524
513-909-1361
515-349-1850
515-421-8098
516-421-7547
516-962-3439
517-234-1999
517-741-0152
518-595-8462
518-703-6191
520-265-1205
520-372-6015
530-551-0309
530-830-0285
531-335-0985
531-455-0860
534-429-1249
539-538-0390
539-538-0917
540-369-3614
540-874-2352
541-524-4104
541-590-2175
551-202-2218
559-330-1202
559-712-7086
561-266-4425
561-559-1140
562-247-0784
562-955-4713
563-241-3002
563-265-0564
567-280-1851
567-323-0591
570-257-2008
570-431-7886
571-370-9095
571-416-0535
573-542-0164
573-568-8013
574-281-9797
574-337-3313
575-414-0029
575-446-3373
580-344-0448
585-226-7524
585-386-3311
586-265-5921
586-894-8031
601-287-5025
601-921-2849
602-805-7037
602-855-9184
605-549-1683
605-991-2968
606-259-4048
607-270-0294
607-270-0465
608-403-4230
608-455-0042
609-431-5593
609-808-2913
610-686-6163
610-750-9006
612-204-2509
614-647-4666
614-929-7306
615-387-9116
615-657-7900
616-272-5669
616-676-7646
617-362-8522
617-675-0450
618-833-4542
618-892-9070
619-345-3158
619-614-0648
620-302-1007
620-790-1528
623-244-1821
626-268-5734
626-784-9833
628-203-5034
629-219-9468
629-348-1397
630-423-7874
630-473-4380
631-488-3377
631-490-4865
631-771-0500
636-259-2495
636-373-8233
640-224-0188
640-444-3223
641-632-2044
641-847-0410
650-285-2286
650-501-0656
651-314-3128
651-760-5925
657-213-6153
657-213-8385
657-331-5452
660-776-9011
660-924-0720
661-455-7236
661-636-6960
662-352-8929
662-368-2823
667-315-0646
667-315-0789
669-254-5097
669-270-1668
678-504-8592
678-782-9196
680-215-0605
680-333-9236
681-243-9992
681-690-2379
682-317-9026
682-348-4970
701-368-4013
701-368-4049
702-209-0052
703-829-0957
704-228-1510
706-309-4276
706-620-0173
707-813-2448
707-854-7604
708-736-9084
708-986-0571
712-340-0189
712-356-8543
713-913-1492
714-253-4798
714-941-0679
715-793-0001
715-793-0621
716-815-3090
716-815-3192
717-685-9720
717-759-0260
719-401-0014
719-982-4816
720-779-1207
720-791-8066
724-920-0756
724-999-8302
725-238-4186
725-245-1618
726-610-3286
727-314-6681
727-339-0864
727-456-9730
727-502-6108
727-201-1890
731-277-5781
731-335-6374
732-444-7712
732-992-3070
734-492-0725
734-519-1262
737-275-5658
737-275-7780
740-309-3636
740-401-9917
743-208-8985
743-213-3516
747-262-5741
747-286-2509
754-202-2551
757-304-0918
757-919-4464
760-205-2826
760-935-6751
762-250-4082
762-250-5482
763-299-9505
763-317-4813
765-313-8355
765-388-5374
769-255-4682
769-869-1026
770-609-3134
770-615-8569
772-888-1697
772-946-9684
773-828-1429
773-828-3562
774-478-6871
774-840-1838
775-237-2234
775-374-5434
779-243-0383
779-903-3197
781-422-8427
781-908-0914
785-384-4230
785-571-9320
786-698-8492
786-753-6329
787-520-5127
787-888-7373
801-210-0941
802-242-1126
802-520-9939
803-766-4404
803-868-5930
804-575-1811
804-606-0729
805-328-2555
805-849-2844
806-337-2843
806-616-6100
808-437-2549
810-243-2511
810-331-0810
812-269-7590
812-329-2052
813-738-5563
813-738-5577
814-647-1485
814-647-1617
815-322-1599
815-407-7769
816-281-8654
816-368-4681
817-415-0741
817-778-9301
818-213-2019
818-570-8951
820-345-7562
820-888-2380
828-417-0553
828-630-9727
830-216-6413
830-368-2146
831-308-2390
831-309-2769
832-481-4223
832-583-0261
832-821-2804
838-388-1371
838-638-0558
843-564-2550
843-605-9753
845-366-6884
845-985-1538
847-461-8054
847-893-0553
848-208-1316
848-249-8777
850-328-3262
850-706-5132
854-204-6422
854-854-9834
856-208-6986
856-378-2227
857-410-1194
857-410-1196
858-206-9467
858-771-4404
859-428-8999
859-592-5837
860-572-6133
860-579-4382
862-330-1829
862-781-0455
863-275-0470
863-440-7974
864-362-6882
864-712-0758
865-248-0090
865-383-7649
870-527-4198
870-627-3206
872-270-3077
872-365-4681
878-212-9998
878-225-9714
888-962-7071
901-667-8044
901-667-8224
903-392-0009
903-993-0013
904-773-4941
904-830-1725
906-265-8339
906-723-8649
907-600-8608
908-378-8399
908-837-7216
909-830-2003
909-830-9544
910-516-8354
910-716-1544
912-500-2716
912-521-6733
913-349-1299
913-423-0059
914-919-9550
914-940-0181
915-295-7127
915-455-1441
916-884-0907
916-884-0923
918-426-9711
918-807-6809
919-891-0031
919-912-1841
920-630-1998
920-944-2675
925-526-0402
925-755-4211
928-337-5040
928-851-6211
929-223-7773
929-588-6402
930-229-0515
930-233-0946
931-240-0871
931-716-5288
934-666-9475
934-948-2711
936-256-3940
936-571-1944
937-739-6999
937-982-1895
938-223-1727
938-465-1744
939-200-2142
939-441-7134
940-227-9918
940-487-9416
941-499-7730
941-529-8208
947-210-2749
947-210-2754
949-216-4071
951-326-1101
951-566-1558
952-204-5587
952-222-5244
954-284-1127
954-417-8872
956-420-3291
956-629-8117
959-202-5644
959-202-5697
970-200-2302
970-289-0943
971-370-8829
971-979-0288
972-430-8987
973-761-2181
973-826-2942
978-533-1077
978-806-4547
979-291-2409
979-330-7398
980-290-6755
980-332-8306
984-377-6045
984-538-0186
985-238-1899
985-323-5497
986-867-0912
986-888-3881
989-442-7760
989-623-9411
Bio-Genetics Laboratory
805 Executive Center Dr. W Ste 100 St Petersburg, FL 33702
Phone 1-727-201-1890 Fax 1-813-983-7876
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