Christopher V. Flores MD, A Medical Corporation
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Effective Date: April 1, 2011 (1st Amended)
Co-Privacy Officers:  Maricela C. Fernández (Office Manager) & Christopher V. Flores MD (Physician).  Telephone: 760-
568-4483.

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.

We understand the importance of privacy and are committed to maintaining the confidentiality of your medical information.
We make a record of the medical care we provide and may receive such records from others. We are required by law to
maintain the privacy of protected health information and to provide individuals with notice of our legal duties and privacy
practices with respect to protected health information. This notice describes how we may use and disclose your medical
information. It also describes your rights and our legal obligations with respect to your medical information.  If you have any
questions about this Notice, please contact our office.  Our Co-Privacy Officers are Maricela C. Fernández (Office Manager)
and Christopher V. Flores MD (Physician) (hereinafter referred to collectively as “Privacy Officer”).

TABLE OF CONTENTS

A.     How This Medical Practice May Use or Disclose Your Health Information

B.     When This Medical Practice May Not Use or Disclose Your Health Information

C.     Your Health Information Rights

    1.        Right to Request Special Privacy Protections
    2.        Right to Request Confidential Communications
    3.        Right to Inspect and Copy
    4.        Right to Amend or Supplement
    5.        Right to an Accounting of Disclosures
    6.        Right to a Paper Copy of this Notice

D.     Changes to this Notice of Privacy Practices

E.     Complaints


A.        How This Medical Practice May Use or Disclose Your Health Information

This medical practice collects health information about you and stores it on a computer. This is your medical record. The
medical record is the property of this medical practice, but the information in the medical record belongs to you. The law
permits us to use or disclose your health information for the following purposes:

    1.     Treatment.  We use medical information about you to provide your medical care. We disclose medical information
    to our employees and others who are involved in providing the care you need. For example, we may share your
    medical information with other physicians or other health care providers who will provide services which we do not
    provide. Or we may share this information with a pharmacist who needs it to dispense a prescription to you, or a
    laboratory that performs a test. We may also disclose medical information to members of your family or others who
    can help you when you are sick or injured.

    2.     Payment.   We use and disclose medical information about you to obtain payment for the services we provide. For
    example, we may need to give your health plan the information it requires so that your health plan will reimburse you
    or pay us (if applicable).  We may also disclose information to other health care providers to assist them in obtaining
    payment for services they have provided to you.

    3.     Health Care Operations.  We may use and disclose medical information about you to operate this medical
    practice. For example, we may use and disclose this information to review and improve the quality of care we provide,
    or the competence and qualifications of our professional staff. Or we may use and disclose this information to get your
    health plan to authorize services or referrals. We may also use and disclose this information as necessary for medical
    reviews, legal services and audits, including fraud and abuse detection and compliance programs and business
    planning and management. We may also share your medical information with our "business associates," that
    perform administrative services for us. We have a written contract with each of these business associates that
    contains terms requiring them to protect the confidentiality and security of your medical information. Although federal
    law does not protect health information which is disclosed to someone other than another healthcare provider, health
    plan or healthcare clearinghouse, under California law all recipients of health care information are prohibited from
    redisclosing it except as specifically required or permitted by law. We may also share your information with other
    health care providers, health care clearinghouses or health plans that have a relationship with you, when they request
    this information to help them with their quality assessment and improvement activities, their efforts to improve health
    or reduce health care costs, their review of competence, qualifications and performance of health care professionals,
    their training programs, their accreditation, certification or licensing activities, or their health care fraud and abuse
    detection and compliance efforts.

    4.     Appointment Reminders.  We may use and disclose medical information to contact and remind you about
    appointments. If you are not home, we may leave this information on your answering machine, on a cell phone
    voicemail, or in a message left with the person answering the phone.

    5.     Sign In Sheet.  We may use and disclose medical information about you by having you sign in when you arrive at
    our office. We may also call out your name when we are ready to see you.

    6.     Notification and Communication With Family.  We may disclose your health information to notify or assist in
    notifying a family member, your personal representative or another person responsible for your care about your
    location, your general condition or in the event of your death. In the event of a disaster, we may disclose information to
    a relief organization so that they may coordinate these notification efforts. We may also disclose information to
    someone who is involved with your care or helps pay for your care. If you are able and available to agree or object, we
    will give you the opportunity to object prior to making these disclosures, although we may disclose this information in
    a disaster even over your objection if we believe it is necessary to respond to the emergency circumstances. If you are
    unable or unavailable to agree or object, our health professionals will use their best judgment in communication with
    your family and others.

    7.     Marketing.  We may contact you to give you information about products or services related to your treatment, case
    management or care coordination, or to direct or recommend other treatments or health-related benefits and services
    that may be of interest to you, or to provide you with small gifts. We may also encourage you to purchase a product or
    service when we see you. If you are currently an enrollee of a health plan, we may receive payment for
    communications to you in conjunction with our provision, coordination, or management of your health care and related
    services, including our coordination or management of your health care with a third party, our consultation with other
    health care providers relating to your care, or if we refer you for health care, but only to the extent these
    communications describe: 1) a provider’s participation in the health plan’s network, 2) the extent of your covered
    benefits, or 3) concerning the availability of more cost-effective pharmaceuticals. We will not accept any payment for
    other marketing communications without your prior written authorization unless you have a chronic and seriously
    debilitating or life-threatening condition and we are making the communication in conjunction with our provision,
    coordination, or management of your health care and related services, including our coordination or management of
    your health care with a third party, our consultation with other health care providers relating to your care, or if we refer
    you for health care. If we make these types of communications to you while you have a chronic and seriously
    debilitating or life-threatening condition, we will tell you who is paying us, and we will also tell you how to stop these
    communications if you prefer not to receive them. We will not otherwise use or disclose your medical information for
    marketing purposes without your written authorization, and we will disclose whether we receive any payments for any
    marketing activity you authorize.

    8.     Required by Law.  As required by law, we will use and disclose your health information, but we will limit our use or
    disclosure to the relevant requirements of the law. When the law requires us to report abuse, neglect or domestic
    violence, or respond to judicial or administrative proceedings, or to law enforcement officials, we will further comply
    with the requirement set forth below concerning those activities.

    9.     Public Health.  We may, and are sometimes required by law to disclose your health information to public health
    authorities for purposes related to: preventing or controlling disease, injury or disability; reporting child, elder or
    dependent adult abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration
    problems with products and reactions to medications; and reporting disease or infection exposure. When we report
    suspected elder or dependent adult abuse or domestic violence, we will inform you or your personal representative
    promptly unless in our best professional judgment, we believe the notification would place you at risk of serious harm
    or would require informing a personal representative we believe is responsible for the abuse or harm.

    10.     Health Oversight Activities.  We may, and are sometimes required by law to disclose your health information to
    health oversight agencies during the course of audits, investigations, inspections, licensure and other proceedings,
    subject to the limitations imposed by federal and California law.

    11.      Judicial and Administrative Proceedings.  We may, and are sometimes required by law, to disclose your health
    information in the course of any administrative or judicial proceeding to the extent expressly authorized by a court or
    administrative order. We may also disclose information about you in response to a subpoena, discovery request or
    other lawful process if reasonable efforts have been made to notify you of the request and you have not objected, or if
    your objections have been resolved by a court or administrative order.

    12.     Law Enforcement.  We may, and are sometimes required by law, to disclose your health information to a law
    enforcement official for purposes such as identifying of locating a suspect, fugitive, material witness or missing
    person, complying with a court order, warrant, grand jury subpoena and other law enforcement purposes.

    13.     Coroners.  We may, and are often required by law, to disclose your health information to coroners in connection
    with their investigations of deaths.

    14.     Organ or Tissue Donation. We may disclose your health information to organizations involved in procuring,
    banking or transplanting organs and tissues.

    15.     Public Safety.  We may, and are sometimes required by law, to disclose your health information to appropriate
    persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the
    general public.

    16.     Specialized Government Functions.  We may disclose your health information for military or national security
    purposes or to correctional institutions or law enforcement officers that have you in their lawful custody.

    17.       Worker’s Compensation.  We may disclose your health information as necessary to comply with worker’s
    compensation laws. For example, to the extent your care is covered by workers’ compensation, we will make periodic
    reports to your employer about your condition. We are also required by law to report cases of occupational injury or
    occupational illness to the employer or workers’ compensation insurer.

    18.     Change of Ownership.  In the event that this medical practice is sold or merged with another organization, your
    health information/record will become the property of the new owner, although you will maintain the right to request
    that copies of your health information be transferred to another physician or medical group.

    19.     Breach Notification.  In the case of a breach of unsecured protected health information, we will notify you as
    required by law. If you have provided us with a current email address, we may use email to communicate information
    related to the breach. In some circumstances our business associate may provide the notification. We may also
    provide notification by other methods as appropriate.

    20.     Research.  We may disclose your health information to researchers conducting research with respect to which
    your written authorization is not required as approved by an Institutional Review Board or privacy board, in compliance
    with governing law.

    21.     Fundraising.  We may use or disclose your demographic information and the dates that you received treatment
    in order to contact you for fundraising activities. If you do not want to receive these materials, notify the Privacy Officer
    listed at the top of this Notice of Privacy Practices and we will stop any further fundraising communications.

    22.     Email. We may communicate with you via email, either secure email via RelayHealth or regular (unencrypted
    email).  We may ask you if you would like to communicate via email and advise you of the two different options (secure
    email via RelayHealth or regular unencrypted email).  While we strongly encourage you to choose the secure email
    option, we will honor your choice if you choose unencrypted email so long as you are aware of and accept all risks
    associated with regular email and so long as the privacy laws permit us to.  

B.        When This Medical Practice May Not Use or Disclose Your Health Information

Except as described in this Notice of Privacy Practices, this medical practice will not use or disclose health information which
identifies you without your written authorization. If you do authorize this medical practice to use or disclose your health
information for another purpose, you may revoke your authorization in writing at any time.

C.        Your Health Information Rights

    1.     Right to Request Special Privacy Protections.  You have the right to request restrictions on certain uses and
    disclosures of your health information by a written request specifying what information you want to limit, and what
    limitations on our use or disclosure of that information you wish to have imposed. If you tell us not to disclose
    information to your commercial health plan concerning health care items or services for which you paid for in full out-of-
    pocket, we will abide by your request, unless we must disclose the information for treatment or legal reasons. We
    reserve the right to accept or reject any other request, and will notify you of our decision.

    2.     Right to Request Confidential Communications.  You have the right to request that you receive your health
    information in a specific way or at a specific location. For example, you may ask that we send information to a
    particular e-mail account or to your work address. We will comply with all reasonable requests submitted in writing
    which specify how or where you wish to receive these communications.

    3.     Right to Inspect and Copy.  You have the right to inspect and copy your health information, with limited exceptions.
    To access your medical information, you must submit a written request detailing what information you want access to
    and whether you want to inspect it or get a copy of it. We will charge a reasonable fee, as allowed by California and
    federal law. We may deny your request under limited circumstances. If we deny your request to access your child’s
    records or the records of an incapacitated adult you are representing because we believe allowing access would be
    reasonably likely to cause substantial harm to the patient, you will have a right to appeal our decision. If we deny your
    request to access your psychotherapy notes, you will have the right to have them transferred to another mental health
    professional. If your written request clearly, conspicuously and specifically asks us to send you or some other person
    or entity an electronic copy of your medical record, and we do not deny the request as discussed above, we will send a
    copy of the electronic health record as you requested, and will charge you no more than what it cost us to respond to
    your request.

    4.     Right to Amend or Supplement.  You have a right to request that we amend your health information that you
    believe is incorrect or incomplete. You must make a request to amend in writing, and include the reasons you believe
    the information is inaccurate or incomplete. We are not required to change your health information, and will provide
    you with information about this medical practice’s denial and how you can disagree with the denial. We may deny your
    request if we do not have the information, if we did not create the information (unless the person or entity that created
    the information is no longer available to make the amendment), if you would not be permitted to inspect or copy the
    information at issue, or if the information is accurate and complete as is. You also have the right to request that we
    add to your record a statement of up to 250 words concerning any statement or item you believe to be incomplete or
    incorrect.

    5.     Right to an Accounting of Disclosures.  You have a right to receive an accounting of disclosures of your health
    information made by this medical practice, except that this medical practice does not have to account for the
    disclosures provided to you or pursuant to your written authorization, or as described in paragraphs 1 (treatment), 2
    (payment), 3 (health care operations), 6 (notification and communication with family) and 16 (specialized government
    functions) of Section A of this Notice of Privacy Practices or disclosures for purposes of research or public health
    which exclude direct patient identifiers, or which are incident to a use or disclosure otherwise permitted or authorized
    by law, or the disclosures to a health oversight agency or law enforcement official to the extent this medical practice
    has received notice from that agency or official that providing this accounting would be reasonably likely to impede
    their activities.

    6.     Right to Paper Copy of Notice.  You have a right to a paper copy of this Notice of Privacy Practices, even if you have
    previously requested its receipt by e-mail.

If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights,
contact our Privacy Officer listed at the top of this Notice of Privacy Practices.

D.        Changes to this Notice of Privacy Practices

We reserve the right to amend this Notice of Privacy Practices at any time in the future. Until such amendment is made, we
are required by law to comply with this Notice. After an amendment is made, the revised Notice of Privacy Protections will
apply to all protected health information that we maintain, regardless of when it was created or received. We will keep a copy
of the current notice posted in our reception area, and a copy will be available at each appointment. We will also post the
current notice on our website.

E.        Complaints

Complaints about this Notice of Privacy Practices or how this medical practice handles your health information should be
directed to our Privacy Officer listed at the top of this Notice of Privacy Practices.  If you are not satisfied with the manner in
which this office handles a complaint, you may submit a formal complaint to:

    Region IX
    Office for Civil Rights
    U.S. Department of Health & Human Services
    90 7th Street, Suite 4-100
    San Francisco, CA 94103
    (415) 437-8310; (415) 437-8311 (TDD)
    (415) 437-8329 FAX
    OCRMail@hhs.gov

The complaint form may be found at www.hhs.gov/ocr/privacy/hipaa/complaints/hipcomplaint.pdf.  You will not be penalized
for filing a complaint.

CHRISTOPHER V. FLORES, MD
A MEDICAL CORPORATION
Mailing Address:  PO Box 752, Rancho Mirage, CA 92270
Office Address:  44331 Monterey Ave, Suites C & D, Palm Desert, CA 92260
Tel:  (760) 568-4483  Fax:(760) 568-6810
www.drchrisflores.com

NOTICE OF PRIVACY PRACTICE