Patient privacy
Notice of Privacy Practices
Effective July 19, 2026
This notice describes how medical information about you may be used and disclosed and how you can get access to it. Please review it carefully.
Your rights
You may ask to inspect or receive an electronic or paper copy of your record; request a correction; ask for confidential communications; ask us to limit certain uses or disclosures; request an accounting of certain disclosures; receive a paper copy of this notice; choose a legally authorized personal representative; and file a complaint without retaliation.
Records and corrections
Ask the office how to make a written records request and verify your identity. We generally respond within 30 days. If permitted by law, we may charge a reasonable, cost-based fee. You may ask us to correct information you believe is inaccurate or incomplete. If we deny a request, we will explain the reason in writing within the time required by law.
Confidential communications and restrictions
You may ask us to contact you in a particular way or at another address. We will agree to reasonable requests. You may also ask us not to use or share certain information for treatment, payment, or operations; we are not always required to agree. If you pay in full out of pocket for a service, you may ask us not to disclose information about that service to your health plan for payment or health-care operations, unless disclosure is required by law.
Complaints
Contact the Privacy Officer at 703-594-1583 or write to 3650 Joseph Siewick Drive, Suite 205B, Fairfax, Virginia 22033. You may also complain to the U.S. Department of Health and Human Services Office for Civil Rights at 200 Independence Avenue, S.W., Washington, DC 20201; 1-877-696-6775; or hhs.gov/hipaa/filing-a-complaint. We will not retaliate against you for filing a complaint.
Your choices
You may tell us your preference about sharing information with family, friends, or others involved in your care or payment, and about sharing in a disaster-relief situation. If you cannot tell us, we may share information when we believe it is in your best interest or when needed to lessen a serious and imminent threat.
We obtain written authorization for marketing, sale of health information, and most uses or disclosures of psychotherapy notes. We do not sell patient information or use it for fundraising. You may revoke an authorization in writing, except to the extent we already relied on it.
How we use and share information
We may use and share health information to treat you, operate the practice, improve care, train staff, conduct quality and safety work, contact you when necessary, bill for services, coordinate authorizations, and obtain payment.
After meeting the conditions required by law, we may also use or disclose information for public-health and safety activities; health research; compliance with law; organ and tissue donation; work with a medical examiner or funeral director; workers' compensation; health oversight; lawful law-enforcement or government requests; and court or administrative proceedings.
Additional protections
Some information receives additional protection under federal or Virginia law. We follow the more protective rule when it applies. This may include certain substance-use-disorder records, psychotherapy notes, genetic information, communicable-disease information, and records concerning minors.
To the extent we maintain substance-use-disorder patient records subject to 42 CFR Part 2, we will not use or disclose those records in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a court order and subpoena, as required by law.
Our responsibilities
- We are required by law to maintain the privacy and security of protected health information.
- We will notify you promptly if a breach occurs that may have compromised your information, as required by law.
- We must follow the duties and practices described in this notice and provide a copy on request.
- We will not use or share information other than as described here unless you authorize us in writing.
Changes to this notice
We may change this notice and make revised terms apply to information we already have as well as information received later. The current notice will be available in the office, on this website, and upon request.
Privacy contact
Privacy Officer, Virginia Surgical Services
3650 Joseph Siewick Drive, Suite 205B
Fairfax, Virginia 22033
703-594-1583
administrator@va-ss.org
Do not include detailed medical information in ordinary email. Call the office for the approved patient-specific channel.