Your Information. Your Rights. Our Responsibilities.
This notice describes how medical information about you may be used and disclosed, how you can get access to this information, and your rights regarding your health information. Please review it carefully.
Your Rights
When it comes to your health information, you have certain rights. Burton Creek Rural Clinic is responsible for helping you exercise these rights.
Get a copy of your medical record
You may ask to see or receive an electronic or paper copy of your medical record and other health information we maintain about you. We will generally provide a copy or summary within the time required by law. We may charge a reasonable, cost-based fee when permitted by law.
Ask us to correct your medical record
You may ask us to correct health information that you believe is incorrect or incomplete. We may deny the request in certain circumstances, but if we do, we will explain the reason in writing.
Request confidential communications
You may ask us to contact you in a specific way, such as at a particular phone number, or to send mail to a different address. We will accommodate reasonable requests.
Ask us to limit what we use or share
You may ask us not to use or share certain health information for treatment, payment, or health care operations. We are not always required to agree to your request.
If you pay for a health care service or item completely out of pocket, you may ask us not to share information about that service with your health insurer for payment or health care operations. We will honor that request unless disclosure is required by law.
Get a list of certain disclosures
You may request an accounting of certain disclosures of your health information made during the six years before your request. Some disclosures, including many made for treatment, payment, and health care operations, are not included.
Get a copy of this notice
You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
Choose someone to act for you
If you have given someone medical power of attorney, or if someone is your legal guardian or otherwise legally authorized to act for you, that person may exercise your privacy rights on your behalf.
File a complaint
You may file a complaint if you believe your privacy rights have been violated. Burton Creek Rural Clinic will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you may tell us your preferences about what we share.
- Share information with family members, friends, or others involved in your care or payment for your care.
- Share information during a disaster-relief situation.
If you are unable to tell us your preference, such as during an emergency, we may share information when we believe it is in your best interest or when necessary to lessen a serious and imminent threat to health or safety.
We generally will not use or disclose your health information for the following purposes without your written authorization:
- Marketing purposes when authorization is required by law.
- The sale of your health information.
- Most uses and disclosures of psychotherapy notes.
If you give us written authorization, you may revoke that authorization in writing at any time, except to the extent that we have already acted on it.
How We May Use and Share Your Health Information
Treatment
We may use your health information and share it with physicians, nurses, pharmacies, laboratories, hospitals, specialists, or other health care professionals involved in your care.
For example, your Burton Creek provider may share relevant information with a specialist who is treating you.
Payment
We may use and share your health information to bill and receive payment from health plans, insurers, or other organizations responsible for paying for your care.
Health care operations
We may use and share your health information to operate our clinic, coordinate services, improve the quality of care, train staff, conduct quality reviews, and contact you when necessary.
Other Uses and Disclosures Permitted or Required by Law
We may use or disclose your health information when permitted or required by law, including for purposes such as:
- Preventing or controlling disease.
- Reporting certain adverse reactions or product problems.
- Reporting suspected abuse, neglect, or domestic violence when permitted or required by law.
- Preventing or reducing a serious threat to health or safety.
- Health oversight activities.
- Certain research activities permitted by law.
- Workers’ compensation claims.
- Certain law-enforcement purposes.
- Military, national-security, or other authorized government functions.
- Organ and tissue donation.
- Coroners, medical examiners, and funeral directors.
- Court orders, administrative proceedings, subpoenas, or other legal processes when permitted by law.
- Compliance with federal or state law.
- Providing information to the U.S. Department of Health and Human Services when required to demonstrate compliance with federal privacy law.
Substance Use Disorder Records
Certain substance use disorder treatment records may receive additional protection under federal law, including 42 CFR Part 2.
To the extent Burton Creek Rural Clinic creates or maintains records protected by Part 2, those records will not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you unless permitted by federal law, such as with your written consent or an appropriate court order and subpoena.
Our Responsibilities
Burton Creek Rural Clinic is required by law to:
- Maintain the privacy and security of your protected health information.
- Provide you with a notice explaining our legal duties and privacy practices.
- Follow the duties and privacy practices described in the notice currently in effect.
- Notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
- Honor your rights regarding your protected health information as required by law.
We will not use or share your information other than as described in this notice unless you authorize us to do so in writing or the law permits or requires the use or disclosure.
Changes to This Notice
We may change the terms of this Notice of Privacy Practices. Changes may apply to all health information we maintain, including information created or received before the change.
The current notice will be available upon request, at Burton Creek Rural Clinic, and on our website.
Questions or Complaints
If you have questions about this notice, would like to exercise one of your privacy rights, or wish to make a complaint, contact:
Burton Creek Rural Clinic
805 N Kentucky Street, Suite 1
West Plains, MO 65775
Phone: (417) 256-2111
Privacy Contact:
Marissa Pearson
Phone: (417) 256-2111
Email: Mpearson@burtonmc.com
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
You may also file a complaint through the HHS Office for Civil Rights website.
We will not retaliate against you for filing a complaint.
Patient Portal
Patients may access available health information electronically through the Burton Creek Rural Clinic Patient Portal.
Effective Date
Effective Date: September 14, 2026