NOTICE OF
PRIVACY PRACTICES

As required by the Privacy Regulations
created as a result of the 

Health Insurance Portability and Accountability Act of 1996
(HIPAA)

THIS NOTICE DESCRIBES HOW HEALTH
INFORMATION ABOUT YOUR CHILD (AS A PATIENT OF OUR PRACTICE) MAY BE USED AND
DISCLOSED, AND HOW YOU CAN GET ACCESS TO YOUR

CHILD’S INDIVIDUALLY IDENTIFIABLE HEALTH
INFORMATION.

A.    OUR COMMITMENT TO YOUR PRIVACY

WeeCare for Kids, PA is dedicated to maintaining the
privacy of your child’s individually identifiable health information
(IIHI).  In conducting our business, we
will create records regarding your child and the treatment and services we
provide to him/her.  We are required by
law to maintain the confidentiality of health information that identifies your
child.  We also are required by law to
provide you with this notice of our legal duties and the privacy practices that
we maintain in our practice concerning your child’s IIHI.  By federal and state law, we must follow the
terms of the notice of privacy practices that we have in effect at the time.

The terms of this notice apply to all records
containing your child’s IIHI that are created by our practice.  We reserve the right to revise or amend this
Notice of Privacy Practices.  Any
revision or amendment to this notice will be effective for all of your child’s
records that our practice has created or maintained in the past, and for any of
your records that we may create or maintain in the future.  Our practice will post a copy of our current
Notice in our office in a visible location at all times, and you may request a copy
of our current Notice at any time.

B.    IF YOU HAVE QUESTIONS ABOUT THIS NOTICE,
PLEASE CONTACT:

Our Privacy Officer at the office or contact (813)
236-9000.

C.    WE MAY USE AND DISCLOSE YOUR CHILD’S IIHI

The following categories describe the different ways
in which we may use and disclose your child's IIHI:

1.   Our
practice may disclose your child’s IIHI to
treat your child. For example,   To order laboratory test.

•        
To write a prescription or call in a prescription
to a pharmacy.

•        
To other health care providers for purposes
related to your child's treatment.

•        
To others who you have given permission to bring
your child to the office for treatment.

2.   In
order to bill and collect payment
for the services and items provided by us for your child. For example:

•        
To contact your child's health insurer to verify
your child is eligible for benefits at the time of service.

•        
Provide your child's insurer with details
regarding your child's treatment to determine if the insurer will cover, or pay
for, your child's treatment.

•        
To other health care providers and entities to
assist in their billing and collection efforts.

3.   Health Care Operations: Our practice
may disclose your child’s IIHI to operate
our business. For example, to evaluate the quality of care your child received
from us.

•        
To contact and remind you of your child’s
appointments.

•        
To inform you of health-related benefits or
services that may be of interest to you.

•        
When we are required to do so by federal, state
or local law.

D.    USE AND DISCLOSURE OF YOUR CHILD'S IIHI IN
CERTAIN SPECIAL CIRCUMSTANCES

The following categories describe unique scenarios in
which we may disclose your child's IIHI to the extent such use or disclosure is
required by law:

1.   Public Health Risks. Our practice may
disclose your child's IIHI to public health authorities that are authorized by
law to collect information for the purpose of:

•        
reporting child abuse or neglect                                                                                                            

•       notifying
a person regarding potential exposure to a communicable disease

•       notifying
a person regarding a potential risk for spreading or contracting a disease or
condition

•       reporting
reactions to drugs or problems with products or devices

2.     Health oversight Activities. Oversight
activities can include investigations, inspections, audits, surveys, licensure
and disciplinary actions; civil, administrative, and criminal procedures or
actions; or other activities necessary for the government to monitor government
programs.

3.     Lawsuits and Similar Proceedings. Our
practice may use or disclose your child's IIHI in response to a court or
administrative order, if you are involved in a lawsuit or similar proceeding.
In response to a discovery request, subpoena, or other lawful process by
another party involved in the dispute.

4.     Law enforcement. For example:

•       Regarding
a crime victim in certain situations

•       Regarding
criminal conduct at our office

•       In
response to a warrant, summons, court order, subpoena or similar legal process

•       To
identify a suspect, witness, fugitive or missing person

5.     Deceased Patients. Our practice may
release IIHI to a medical examiner or coroner to identify a deceased individual
or to identify the cause of death.

6.     Serious threats to health or safety.

7.     Worker’s compensation.

8.     Research. Our practice may use and
disclose your child's IIHI for research purposes in certain limited
circumstances. We will obtain your written authorization to use your child's
IIHI for research purposes.

9.     Compliance. We are required to disclose
your child's IIHI to the Secretary of the Department of Health and Human
Services or his designee upon request to investigate our compliance with HIPAA.

E. YOU HAVE THE FOLLOWING RIGHTS REGARDING
THE IIHI THAT WE MAINTAIN:

1.     Confidential Communications. You may
request that our practice communicate with you about your child’s health and
related issues in a particular manner or at a certain location.  In order to request a type of confidential
communication, you must make a written request to the Privacy Officer  specifying the requested method of contact or
the location where you wish to be contacted. Our practice will accommodate reasonable requests.  

2.     Requesting Restrictions. You have the
right to request that we limit the
use or disclosure of your child’s IIHI for treatment, payment, or health care
operations.  In order to request a
restriction in our use or disclosure of your child's IIHI, you must make your
request in writing to the Privacy Officer, describing the information you wish
restricted, and to whom you want the limits to apply. Once we agree to your
request, we must follow your restrictions (except if the information is
required by law or necessary for emergency treatment). You may cancel the
restrictions at any time.

3.     Inspection and Copies. You have the
right to inspect and obtain a copy of the IIHI that may be used to make
decisions about your child, including patient medical records and billing
records, but not including psychotherapy notes. 
You must submit your request in writing to the Privacy Officer. Our
practice may charge a fee for the costs of copying, mailing, labor and supplies
associated with your request.

4.     Amendment. You may ask us to amend your
child's health information if you believe it is incorrect or incomplete. To
request an amendment, your request must be made in writing and submitted to the
Privacy Officer. You must provide us with a reason that supports your request
for amendment. We may deny your request if you ask us to amend information that
is in our opinion: (a) accurate and complete; or (b) not part of the IIHI kept
by our practice.

5.     Accounting of Disclosures. You have the
right to request a list of instances where our practice has disclosed your
child's IIHI for reasons other than treatment, payment for serviced, our
healthcare operations, or disclosure you gave us authorization to make for six
(6) years prior to the date of your request. If you request this information
more than once every twelve (12) months, we may charge a reasonable fee for
subsequent requests.

6.     Right to a Paper Copy of This Notice.

7.     Right to File a Complaint. If you
believe your privacy rights have been violated, you may file a complaint with
our practice or with the Secretary of the Department of Health and Human
Services. File a written complaint with our practice at 11948 Balm Riverview
Rd, Riverview, Florida 33569. You will not be penalized for filing a complaint.

8.     Right to Provide an Authorization for Other
Uses and Disclosures. Our practice will obtain your written authorization for uses and disclosures that are not
identified by this notice or permitted by applicable law.

Again, if you have any questions regarding this
notice or our health information privacy policies, please contact our Privacy
Officer at 11948 Balm Riverview Rd., Riverview, Florida 33569.