Effective Date: [Insert Date]
Business Name: RUR HOPE CLINIC

1. Overview

In addition to federal privacy regulations, RUR HOPE CLINIC complies with Wisconsin laws governing medical and mental health information, including Wisconsin Statute §146.81–146.84, which governs the confidentiality of patient health care records.

2. Confidentiality of Health Care Records

• We are legally required to keep your health care records confidential and will only disclose them with your written informed consent or as permitted under Wisconsin law.
  
  
• Mental health treatment notes and records receive additional protection and require specific authorization before being shared with third parties.
  
  

3. Patient Access Rights

Under Wisconsin law, you have the right to:

• Inspect and request a copy of your medical and mental health records.
  
  
• Request corrections or amendments to your health information if it is inaccurate or incomplete.
  
  
• Receive a record of disclosures showing when and why your information has been shared.
  
  

4. Disclosures Without Consent

We may disclose information without your written authorization only in the following circumstances:

• Emergencies where disclosure is necessary to prevent harm.
  
  
• To other health care providers involved in your treatment.
  
  
• If required by law (court orders, mandatory reporting of abuse, or threats of self-harm/harm to others).
  
  
• For billing and insurance processing within allowed legal limits.
  
  

5. Mental Health Treatment Specific Rules

Wisconsin law provides additional safeguards for psychiatric treatment records:

• Psychotherapy notes are kept separate from other medical records and require explicit patient authorization to share.
  
  
• Certain disclosures (e.g., for research or educational purposes) require de-identification or separate written consent.
  
  

6. Data Security

We use administrative, technical, and physical safeguards to protect your health information from unauthorized access or disclosure.

7. Reporting Violations

If you believe your Wisconsin privacy rights have been violated, you may:

• Contact RUR HOPE CLINIC directly.
  
  
• File a complaint with the Wisconsin Department of Health Services or the U.S. Department of Health and Human Services.
  
  

8. Contact Information

For questions or to exercise your Wisconsin privacy rights:

• RUR HOPE CLINIC
  
  
• Phone: 414-260-5553
  
  
• Email: info@rurhopeclinic.com
  
  
• Location: Wisconsin, USA