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.

This Notice is provided to you pursuant to the Health Insurance Portability and
Accountability Act of 1996 and its implementing regulations (“HIPAA”). It is
designed to tell you how we may, under federal law, use or disclose your Health
Information.

I. We May Use or Disclose Your Health Information for Purposes of Treatment,
Payment or Healthcare Operations without Obtaining Your Prior Authorization
and Here is One Example of Each:
We may provide your Health Information to other health care professionals –
including doctors, nurses and technicians -- for purposes of providing you with care.
Our billing department may access your information – and send relevant parts – to
other insurance companies or government programs to allow us to be paid for the
services we render to you.
We may access or send your information to our attorneys or accountants in the event
we need the information in order to address one of our own business functions.

II. We May Also Use or Disclose Your Health Information Under the Following
Circumstances without Obtaining Your Prior Authorization:
To Notify and/or Communicate with your Family. Unless you tell us you object,
we may use or disclose your Health Information in order to notify your family or
assist in notifying your family, your personal representative or another person
responsible for your care about your location, your general condition or in the event
of your death. If you are unable or unavailable to agree or object, our health
professionals will use their best judgment in any communications with your family
and others.

As Required by Law.

For Public Health Purposes. We may use or disclose your Health Information to
provide information to state or federal public health authorities, as required by law to
prevent or control disease, injury or disability; to report child abuse or neglect; report
domestic violence; report to the Food and Drug Administration problems with
products and reactions to medications; and report disease or infection exposure.

For Health Oversight Activities. We may use or disclose your Health Information
to health oversight agencies during the course of audits, investigations, certification
and other proceedings.

In Response to Civil Subpoenas or for Judicial and Administrative Proceedings.
We may use or disclose your Health Information, as directed, in the course of any
civil administrative or judicial proceeding. However, in general, we will attempt to
ensure that you have been made aware of the use or disclosure of your Health
Information prior to providing it to another person.

To Law Enforcement Personnel. We may use or disclose your Health Information
to a law enforcement official to identify or locate a suspect, fugitive, material witness
or missing person, comply with a court order or grand jury subpoena and other law
enforcement purposes.

To Coroners or Funeral Directors. We may use or disclose your Health
Information for purposes of communicating with coroners, medical examiners and
funeral directors.

For Purposes of Organ Donation. We may use or disclose your Health Information
for purposes of communicating to organizations involved in procuring, banking or
transplanting organs and tissues.

For Public Safety. We may use or disclose your Health Information in order to
prevent or lessen a serious and imminent threat to the health or safety of a particular
person or the general public.

To Aid Specialized Government Functions. If necessary, we may use or disclose
your Health Information for military or national security purposes.

For Worker’s Compensation. We may use or disclose your Health Information as
necessary to comply with worker’s compensation laws.

To Correctional Institutions or Law Enforcement Officials, if you are an
Inmate.

III. For All Other Circumstances, We May Only Use or Disclose Your Health
Information After You Have Signed an Authorization.
If you authorize us to use or disclose your Health Information for another purpose, you
may revoke your authorization in writing at any time.

IV. State Law Impact.
To the extent that state law is more restrictive with respect to
our ability to use or disclose your Health Information, or to the extent that it affords
you greater rights with respect to the control of your Health Information, we will
follow state law. This may arise if your Health Information contains information
relating to HIV/AIDS, mental health, alcohol and/or substance abuse, genetic testing,
among others.

V. You Should Be Advised that We May Also Use or Disclose Your Health
Information for the Following Purposes:
Appointment Reminders. We may use your Health Information in order to contact
you to provide appointment reminders or to give information about other treatments
or health-related benefits and services that may be of interest to you.

VI. Your Rights.
1. You have the right to request restrictions on the uses and disclosures of your
Health Information. However, we are not required to comply with your request.
2. You have the right to receive your Health Information through confidential
means through a reasonable alternative means or at an alternative location.
3. You have the right to inspect and copy your Health Information. We may charge
you a reasonable cost-based fee to cover copying, postage and/or preparation of a
summary.
4. You have a right to request that we amend your Health Information that is
incorrect or incomplete. We are not required to change your Health Information
and will provide you with information about our denial and how you can disagree
with the denial.
5. You have a right to receive an accounting of disclosures of your Health
Information made by us, except that we do not have to account for disclosures:
authorized by you; made for treatment, payment, health care operations; provided
to you; provided in response to an Authorization; made in order to notify and
communicate with family; and/or for certain government functions, to name a
few.
6. You have a right to a paper copy of this Notice of Privacy Practices. 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 us using the information
provided below.

VII. Our Duties.
We are required by law to maintain the privacy of your Health Information and to
provide you with a copy of this Notice.
We are also required to abide by the terms of this Notice.
We reserve the right to amend this Notice at any time in the future and to make the
new Notice provisions applicable to all your Health Information – even if it was
created prior to the change in the Notice. If such amendment is made, we will
immediately display the revised Notice at our office. We will provide you with
another copy, of this Notice at any time, upon request.

VIII. Complaints to the Government.
You may make complaints to the Secretary of the Department of Health and Human
Services (“DHHS”) if you believe your rights have been violated.
We promise not to retaliate against you for any complaint you make to the
government about our privacy practices.

IX. Contact Information.
You may contact us about our privacy practices by writing or calling us at:

Olesen Logistical Management Group
4625 East Bay Drive, Suite 222
Clearwater, FL 33764
Phone: 866-535-0905
Fax: 727-535-0955