Patient Resources · Privacy
How we use and protect your health information — and the rights you have over it.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
The law requires us to keep your medical information private, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect. This notice explains how we may use and share your protected health information (“PHI”), and your rights regarding that information.
We may use and share your PHI in the following ways without your written authorization:
For treatment. We will use your PHI to provide, coordinate, or manage your care — for example, sharing information with other providers involved in your treatment or with a laboratory or pharmacy.
For payment. We will use your PHI to bill and collect payment from you, your insurance company, or a third party — for example, sending information your health plan requires before it pays for your care.
For health care operations. We may use your PHI for our operations, such as quality assessment, staff training, licensing, and other activities needed to run the practice and make sure our patients receive quality care.
Appointment reminders and communications. We may contact you to remind you of an appointment, tell you about test results, or provide information about treatment alternatives or other health-related benefits and services that may interest you, using the contact information and message permissions you have given us.
People involved in your care. Unless you object, we may share relevant information with a family member, friend, or other person you identify who is involved in your care or in payment for your care.
As required by law. We may disclose your PHI when federal, state, or local law requires it.
Public health and safety. We may share PHI for public health activities, such as reporting diseases, injuries, and information about products or medications under FDA oversight.
Health oversight. We may share PHI with a health oversight agency for activities authorized by law, such as audits, investigations, inspections, and licensing.
Lawsuits and legal proceedings. If you are involved in a lawsuit or dispute, we may disclose PHI in response to a court or administrative order, subpoena, or other lawful process.
Law enforcement. We may disclose PHI to law enforcement as permitted or required by law — for example, to report certain injuries, comply with a court order or warrant, or identify or locate a suspect, witness, or missing person.
Death and donation. We may share PHI with coroners, medical examiners, and funeral directors as needed for their duties, and to facilitate organ, eye, or tissue donation.
Research. Under limited circumstances and with required safeguards or approvals, we may use or share PHI for research.
Serious threats. We may use or share PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Specialized government functions and workers' compensation. If you are a member of the armed forces, an inmate, or in law enforcement custody, or if national security or workers' compensation laws apply, we may share PHI as those programs require.
Uses and disclosures of your PHI for marketing purposes, disclosures that constitute a sale of your PHI, and any use or disclosure not described in this notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.
Right to inspect and copy. You may ask to see or get an electronic or paper copy of your medical record and other PHI we have about you. We will provide a copy or summary usually within 30 days of your request, and may charge a reasonable, cost-based fee.
Right to amend. You may ask us to correct PHI you believe is incorrect or incomplete. We may say no to your request, but we will tell you why in writing within 60 days.
Right to an accounting. You may ask for a list (accounting) of the times we have shared your PHI for six years prior to your request, who we shared it with, and why. This does not include disclosures for treatment, payment, or health care operations and certain other disclosures.
Right to request restrictions. You may ask us not to use or share certain PHI for treatment, payment, or operations. We are not required to agree, except that we must agree not to disclose PHI to your health plan about an item or service you paid for in full out of pocket, when you ask us not to share it for payment or operations.
Right to confidential communications. You may ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say yes to all reasonable requests.
Right to a copy of this notice. You may ask for a paper copy of this notice at any time, even if you agreed to receive it electronically. The notice is also posted on our website.
Right to have someone act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your PHI.
Right to breach notification. You will be notified promptly if a breach occurs that may have compromised the privacy or security of your information.
We are required by law to maintain the privacy and security of your PHI, to let you know if a breach occurs that may have compromised it, and to follow the duties and privacy practices described in this notice. We will not use or share your information other than as described here unless you tell us we can in writing.
We reserve the right to change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available in our office and on our website, and we will provide a copy on request.
If you believe your privacy rights have been violated, you may file a complaint with our practice or with the U.S. Department of Health and Human Services. To file a complaint with us, contact our Privacy Official at the address or phone number below. You will not be penalized or retaliated against for filing a complaint.
To ask questions about this notice, exercise any of the rights above, or obtain a copy, contact: Office Manager, Dilworth Dermatology and Laser, 719 East Blvd, Charlotte, NC 28203, (704) 376-9849.
Effective date: November 11, 2026
Make a request — use this form to exercise any of the rights above. Your request goes to our Privacy Official.
Tell us your choices — use this form to share your preferences, or to change a choice you made earlier. Your message goes to our Privacy Official.
Send a question or complaint — use this form to reach our practice manager directly.
Request an appointment online in a couple of minutes, or call the office and we will find a time that works.
