NOTICE OF PRIVACY POLICIES AND PRACTICES
Updated November 25, 2025
This Notice of Privacy Practices applies to all locations, physicians, staff, employees, volunteers, trainees, and business associates of Siouxland Obstetrics & Gynecology, PC (Siouxland OBGYN).
It covers all records of your care maintained by Siouxland OBGYN. Your personal physician may follow additional privacy practices for records created in their private office.
Our Commitment to Your Privacy
We understand that your medical information is personal, and we are committed to protecting it. We create and maintain records of the care and services you receive to provide high-quality services and to comply with legal requirements.
By law, we are required to:
Keep your medical information private.
Provide you with this Notice of Privacy Practices.
Follow the terms of the notice currently in effect.
Notify you in the event of a breach of unsecured protected health information.
Changes to This Notice
We may change our privacy policies at any time. Changes will apply to all medical information we maintain, including information collected before the change. Any significant changes will be posted in our facilities and on our website, and copies will be available upon request.
During your initial visit, you will be asked to acknowledge receipt of this notice.
How We May Use and Disclose Your Medical Information
1. For Treatment
We may use and disclose your information to provide, coordinate, or manage your health care—for example, sending information to a specialist during a referral.
We may also use a secure AI-assisted documentation tool to support clinical note-taking.
2. For Payment
Includes submitting claims to your insurance company, verifying coverage, and obtaining payment.
3. For Health Care Operations
Includes activities such as quality improvement, staff training, medical education, and business management.
Other Uses and Disclosures Permitted Without Your Authorization
We may use or disclose your information for the following:
Public health activities (reporting communicable diseases, exposures, adverse events, product recalls).
Vital records (births and deaths).
Abuse, neglect, or domestic violence reporting.
Health oversight activities (audits, inspections, licensure).
Legal proceedings (court orders, subpoenas, warrants).
Research under strict privacy protections and only after required approvals.
Coroners, medical examiners, and funeral directors as needed to perform their duties.
Organ and tissue donation coordination.
Workers’ compensation programs.
Law enforcement in specific legally permitted situations.
Correctional institutions if you are an inmate.
Military or national security authorities as required by law.
Business associates who perform contracted services, bound by law and contract to safeguard your information.
We May Contact You For
Appointment reminders
Treatment alternatives or health-related services
Communication with family or friends involved in your care
Disaster relief efforts to locate or notify family of your condition
Uses Requiring Your Written Authorization
We will obtain your written authorization before:
Using or disclosing psychotherapy notes
Using your information for marketing purposes
Selling your health information
Any use or disclosure not described in this notice
You may revoke your authorization at any time in writing.
Your Rights Regarding Your Medical Information
You have the right to:
1. Access Your Records
You may inspect or request a copy of your medical records. A reasonable fee may apply. If access is denied, you may request a review of the denial.
2. Request an Amendment
If you believe your record is incorrect or incomplete, you may request an amendment in writing. If denied, you may appeal in writing.
3. Receive an Accounting of Disclosures
You may request a list of disclosures made for purposes other than treatment, payment, or operations. The list may cover up to six years. The first request in a 12-month period is free.
4. Request Confidential Communications
You may request that we contact you by alternative means or at an alternative address.
5. Request Restrictions
You may request restrictions on the use or disclosure of your information. While we are not required to agree to most restrictions, we must accept a restriction that:
Relates to information shared with your health plan,
Concerns an item or service you paid for in full,
And is not otherwise required by law.
6. Request a Paper Copy
You may request a paper copy of this notice at any time, even if you received it electronically.
Please submit all written requests to our Privacy Office listed at the top of this notice.
State Health Information Exchanges
Siouxland OBGYN is located in, and may serve patients from, states that participate in internet-based Health Information Exchanges (HIEs). These systems allow participating health care providers to securely share your health information for treatment, payment, and health care operations.
If Siouxland OBGYN participates in such an exchange, your information will be included unless you choose to opt out.
If you bring a family member or friend into the exam room, this is considered implied consent for discussing relevant medical details.
For More Information or to Report a Concern
If you have any questions about this Notice or believe your privacy rights have been violated, you may contact:
Siouxland OBGYN, PC – Privacy Officer
📍 2730 Pierce Street, Ste 201
📍 Sioux City, IA 51104
📞 (712) 277-3141