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Ste. Genevieve County Ambulance District
P.O. Box 401
Ste. Genevieve, MO 63670


Office Manager









Our pledge
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. A record of the care and services you received is created. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by the Ste. Genevieve County  Ambulance District.Who will follow this notice
  • All departments and units of the ambulance service
  • Any member of a volunteer group we allow to help you while you are in the care of the ambulance service.
  • Health care students performing clinical educational time with the ambulance service.
Uses and Disclosures
Treatment Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For example, results of tests and procedures while  you were being transported  will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.


Payment: Your health information may be used to seek payment from your health plan, from other sources of coverage such as an automobile insurer, worker’s compensation, or from companies that you may use to pay for services. For example, your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated.

Health Care Operations:  Your health information may be used as necessary to support the day-to-day activities and management of Ste. Genevieve County Ambulance District. For example, information on the services you received may be used to support budgeting and financial reporting, and activities to evaluate and promote quality.


As Required By Law: We will disclose medical information about you when required to do so by federal, state, or local law.


Law enforcement: Your health information may be disclosed to law enforcement agencies to support government audits and inspections, to facilitate law-enforcement investigations, and to comply with government-mandated reporting.


Public Health Reporting: Your health information may be disclosed to public health agencies as required by law.
  • To prevent or control disease.
  • To report births and deaths.
  • To report medication reactions or problems.
Health Oversight Activities: We may disclose medical information to a health oversight agency for activities authorized by law. This includes the Missouri Department of Health and Senior Services.


National Security: We may disclose medical information to authorized federal officials for intelligence, homeland security and the protection of national security


Other Uses and Disclosures Require Your Authorization: Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use or disclosure of your information you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision to revoke your authorization.


Individual Rights
You have certain rights under the federal privacy standards. These include:
  • The right to request restrictions on the use and disclosure of your protected health information.
  • The right to receive confidential communications concerning your medical condition & treatment.
  • The right to inspect and copy your protected health information.
  • The right to amend or submit corrections to your protected health information.
  • The right to receive an accounting of how and to whom your protected health information has been disclosed.
  • The right to receive a printed copy of this notice.


Ste. Genevieve County Ambulance District Duties
We are required by law to maintain the privacy of your protected health information and to provide you with this notice of privacy practices. We also are required to abide by the privacy policies and practices that are outlined in this notice.


Right to Revise Privacy Practices
As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Upon request, we will provide you with the most recently revised notice on any transport. The revised policies and practices will be applied to all protected health information we maintain.


Requests to Inspect Protected Health Information
You may generally inspect or copy the protected health information that we maintain. As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting our Office Manager or Privacy Officer. Your request will be reviewed and will generally be approved unless there are legal or medical reasons to deny the request.


If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to: 


Privacy Officer
Ste. Genevieve County Ambulance District
3 Basler Drive – P.O. Box 401
Ste. Genevieve, MO 63670


If you believe that your privacy rights have been violated, you may file a complaint with the Ambulance Service Director or with the Secretary of the Department of Health and Human Services. You will not be penalized or otherwise retaliated against for filing a complaint.


Effective Date
April 14, 2003.


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