Pediatrics West (720) 284-3700		Illness/Symptom ------------------------------ Abdominal Pain Animal or Human Bite Arm Injury Arm Pain Asthma Attack Athlete's Foot Bee or Yellow Jacket Sting Bottle-Feeding (Formula) Questions Breast-Feeding Questions Burns Chest Pain Chickenpox Circumcision Problems Colds Constipation Cough Croup Crying Baby - Before 3 Months Old Crying Child 3 Months and Older- Ir.. Diaper Rash Diarrhea Drinking Fluids - Decreased Ear - Pulling At or Itchy Ear - Swimmer Ear Congestion Ear Discharge Ear Injury Earache Eye - Allergy Eye - Foreign Body Eye - Pus or Drainage Eye - Red Without Pus Eye Injury Fever Fever - How to Take the Temperature Fever - Myths Versus Facts Finger or Toe Injury Genital Injury Hand-Foot-Mouth Disease Hay Fever (Nasal Allergies) Head Injury Headache Hives Immunization Reactions Impetigo - Infected Sores Infection Exposure Questions - Cont.. Influenza Insect Bites Jaundiced Newborn Leg Injury Leg Pain Lice - Head Lymph Nodes - Swollen Mouth Injury Mouth Ulcers Newborn Appearance Questions Newborn Illness - How to Recognize Newborn Rashes and Birthmarks Newborn Reflexes and Behavior Nose Injury Nosebleed Pinworms Poison Ivy - Oak - Sumac Puncture Wound Rash - Localized And Cause Unknown Rash - Widespread And Cause Unknown Ringworm Sinus Pain or Congestion Skin Foreign Body Skin Injury (Cuts, Scrapes, Bruises.. Sore Throat Spider Bite Spitting Up - Reflux Stools - Blood In Stools - Unusual Color Strep Throat Exposure Sunburn Suture Questions Swine Flu (H1N1 Flu) Swine Flu (H1N1 Flu) Exposure Tear Duct - Blocked Teething Teething Thrush Tick Bite Tooth Injury Toothache Umbilical Cord Symptoms Urination Pain Vaginal Itching or Irritation Vomiting Wheezing (Other Than Asthma) Wound Infection Medicines/Dosages ------------------------------ Acetaminophen Cold Medicines Cough Medicines Ibuprofen Itching/Allergies What's Going Around?

Notice of Privacy Practices PEDIATRICS WEST, P.C. NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOUR CHILD MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION, PLEASE REVIEW IT CAREFULLY. Purpose of this Notice In the course of doing business, Pediatrics West gathers and retains personal information about our patients. Pediatrics West respects the privacy of this personal information and understands the importance of keeping this information confidential and secure. This Notice describes how Pediatrics West protects the confidentiality of the personal information that we receive. Pediatrics West has implemented policies and procedures in accordance with Federal and State confidentiality of your personal information. Pediatrics West is also obligated to provide you with the notice of its legal obligations and to maintain the privacy of your personal information and to provide you notice of its policies and procedures about privacy and confidentiality. These policies and procedures apply to past, present and future personal information. What is “Personal Information”? “Personal information” is information that identifies who you are and relates to, your past, present, or future physical or mental health or condition, the provision of health care to you, or past present, or future payment for the provision of health care to you. Personal information does not include information about you that is publicly available, or that is available or reported in summary form, but does not identify who you are. Types of Uses and Disclosures of Personal Information Made by Pediatrics West Federal law allows Pediatrics West to use and disclose your personal information in order to provide health care services to your child/children as well as to bill and collect payments for health care services provided to you by participating physicians. Federal law also allows Pediatrics West to use and disclose your personal information as necessary in connection with the health care operations of Pediatrics West. For example, Pediatrics West may use your personal information to authorize referrals to specialists and to review the quality of care provided by your participating physician, Pediatrics West may disclose your personal information to health plans or responsible parties to receive payment for the services provided by your participating physician. Pediatrics West might also use your personal information in connection with any grievance or appeal that you file if you are unhappy with the care you have received. Certain governmental agencies may also request access to your personal information in order to monitor the activities of certain physicians or providers, or even to monitor your health plan or insurance company. Pediatrics West may use your personal information in connection with disease management programs. Pediatrics West may disclose personal information in connection with court orders or subpoenas. Any Business Associates performing services for Pediatrics West and who may have access or personal information have signed a Business Associate Agreement that they will comply with Federal patient privacy laws (HIPAA) and will take all required steps necessary to protect confidential health information of Pediatrics West patients. While Federal law allows Pediatrics West and health care providers to use and disclose your personal information for treatment, payment, and health care operations, the law requires these providers to obtain your written consent to do so. Therefore, the first time you see Pediatrics West participating physicians once the federal rules take effect, the participating physician will ask you to sign a consent form allowing the physician to use and disclose your child/children’s personal information in connection with the treatment, the payment for the treatment, and the physician’s health care operations. Pediatrics West is also allowed< Last Updated Thursday, April 17, 2003

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