Purpose of This Notice
This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review carefully.
Our Pledge
ER Of Fort Worth is committed to protecting the privacy of your health information as required by the Health Insurance Portability and Accountability Act (HIPAA).
Uses and Disclosures
We may use and disclose your health information for treatment, payment, and healthcare operations without your authorization. Other uses and disclosures require your written authorization unless permitted by law (such as public health reporting, law enforcement requests, court orders, and workers' compensation).
Your Health Information Rights
- Right to access your medical records
- Right to request amendments
- Right to an accounting of disclosures
- Right to request restrictions on certain uses and disclosures
- Right to request confidential communications
- Right to a paper copy of this notice
- Right to file a complaint without retaliation
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer at 817-945-4200 or with the U.S. Department of Health and Human Services Office for Civil Rights.
Effective Date
This notice is effective January 2026 and remains in effect until we modify or replace it.