Pediatric Partners, LLC

Van S. McCorkle, M.D.

Board Certified in Pediatrics

Ingrid R. Newman, M.D.

Board Certified in Pediatrics

Jessi Flynn, APRN-BC, PNP


Lauren Lariscy, APRN-BC, PNP

Notice of Privacy Practices for Protected Health Information
PHI (Effective 01/01/2003)


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!


If you consent, Pediatric Partners, LLC is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment, and health care operations. Protected health information is the information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination and test results, diagnoses, treatment, and applying for future care or treatment. It also Includes billing documents for those services.


Examples of uses of your health information for treatment purposes are:

Example of use of your health information for payment purposes:

Example of Use of Your Information for Health Care Operations:


Your Health Information Rights Example


The health and billing records we maintain are the physical property of our office. The information in it, however, belongs to you. You have a right to:

If you want to exercise any of the above rights, please contact the Administrator, in person or in writing, during normal hours. They will provide you with assistance on the steps to take to exercise your right. You have the right to review this Notice before signing the consent authorizing use and disclosure of your protected health information for treatment, payment and health care operations purposes.

Pediatric Partners, LLC is required to:


We reserve the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the protected health information we maintain. If our information practices change, we will amend our Notice. You are entitled to receive a revised copy of the Notice by calling and requesting a copy of our “Notice” or by visiting our office and picking up a copy.


To Request Information or File a Complaint


If you have questions, would like additional information, or want to report a problem regarding the handling or your information, you may contact the Administrator (706) 548-1216.


Additionally, if you believe your privacy rights have been violated, you may file a written complaint at our office by delivering the written complaint to the Administrator. You may also file a complaint by mailing it or e-mailing it to the Secretary of Health and Human Services.


Other Disclosures and Uses


Notification - Unless you object, we may use or disclose your protected health information to notify. or assist in notifying a family member, personal representative, or other person responsible for your care, about your location, and about your general condition, or your death.


Communication with Family - Using our best judgment, we may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person's involvement in your care or in payment for such care if you do not object or in an emergency.


Disaster Relief - We may use and disclose your protected health information to assist in disaster relief efforts.


Funeral Directors or Coroners - We may disclose your protected health information to funeral directors or coroners consistent with applicable law to allow them to carry out their duties.


Organ Procurement Organizations - Consistent with applicable law, we may disclose your protected health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.


Marketing - We may contact you to provide you with appointment reminders, with information about treatment alternatives, or with information about other health-related benefits and services that may be of interest to you.


Public Health - As required by law, we may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.


Abuse & Neglect - We may disclose your protected health information to public authorities as allowed by law to report abuse or neglect.


Correctional Institutions - If you are an inmate of a correctional institution, we may disclose to the institution or its agents the protected health information necessary for your health and the health and safety of other individuals.


Law Enforcement - We may disclose your protected health information for law enforcement purposes as required by law, such as when required by a court order, or in cases involving felony prosecutions, or to the extent an individual is in the custody of law enforcement.


Health Oversight - Federal law allows us to release your protected health information to appropriate health oversight agencies or for health oversight activities.


Judicial/Administrative Proceedings - We may disclose your protected health information in the course of any judicial or administrative proceeding as allowed or required by law, with your consent, or as directed by a proper court order.


Serious Threat to Health or Safety - To avert a serious threat to health or safety, we may disclose your protected health information consistent with applicable law to prevent or lessen a serious, imminent threat to the health or safety of a person or the public.


For Specialized Governmental Functions - We may disclose your protected health information for specialized government functions authorized by law such as to Armed Forces personnel, for national security purposes, or to public assistance program personnel.


Other Uses - Other uses and disclosures besides those identified in this Notice will be made only as otherwise authorized by law or with written authorization and you may revoke the authorization as previously provided.


Website - If we maintain a website that provides information about our entity, this Notice will be on the website.