NOTICE OF PRIVACY PRACTICES
International Vein & Skin Institute SC
d/b/a
Vein & Skin Institute
Effective Date: February 11, 2026
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
If you have any questions about this Notice, please contact our office at:
International Vein & Skin Institute SC
760 Busse Highway
Park Ridge, IL 60068
📞 (847) 518-9999
1. OUR LEGAL DUTIES
International Vein & Skin Institute SC (“IVSI,” “the Practice,” “we,” or “our”) is required by federal and Illinois law to:
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Maintain the privacy of your protected health information (PHI)
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Provide you with this Notice of our legal duties and privacy practices
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Follow the terms currently in effect
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Notify you if a breach occurs that may compromise your unsecured PHI
We reserve the right to revise this Notice at any time. Any revision will apply to all PHI we maintain. A current copy is available in our office and on our website.
2. HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION
A. Treatment
We may use and disclose your PHI to provide, coordinate, or manage your medical care.
Examples include:
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Referring you to specialists or laboratories
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Reviewing pathology or diagnostic results
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Consulting with other healthcare providers involved in your care
B. Payment
We may use and disclose your PHI to obtain payment for services rendered.
Examples include:
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Submitting claims to insurance carriers
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Obtaining pre-authorizations
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Providing required documentation to third-party payers
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Billing and collection activities
If you pay in full out-of-pocket for a specific service and request that we not disclose that information to your health plan for payment or healthcare operations purposes, we will comply unless disclosure is required by law.
C. Healthcare Operations
We may use or disclose your PHI for operational purposes necessary to run the practice, including:
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Quality assessment and improvement
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Administrative and business management
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Licensing and regulatory compliance
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Appointment reminders
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Post-procedure follow-up communication
We may call your name in the waiting area when your provider is ready to see you.
3. MINIMUM NECESSARY STANDARD
We limit the use, disclosure, and request of PHI to the minimum necessary to accomplish the intended purpose, as required by law.
Workforce members may perform multiple operational functions within the practice. Access to protected health information (PHI) is limited to the minimum necessary to perform assigned job responsibilities in accordance with applicable privacy regulations.
We rely on representations from public officials, other covered entities, and business associates that their requests are for the minimum necessary information.
4. BUSINESS ASSOCIATES
We may share PHI with third-party service providers (“business associates”) who perform services on our behalf, including:
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Billing services
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Practice management software vendors and IT support providers
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Electronic medical record (EMR) vendors and IT support providers
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Laboratory and pathology services
We maintain written agreements with all business associates requiring them to safeguard your PHI in accordance with federal and state privacy laws.
5. OTHER PERMITTED OR REQUIRED DISCLOSURES
We may disclose your PHI without your authorization when required or permitted by law, including:
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Public health reporting
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Health oversight audits or investigations
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Reporting abuse, neglect, or domestic violence
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Judicial or administrative proceedings
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Law enforcement purposes
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Coroners or medical examiners
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Workers’ compensation claims
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To prevent a serious threat to health or safety
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Compliance with Illinois FOID mental health reporting requirements, when applicable
6. USES REQUIRING YOUR WRITTEN AUTHORIZATION
We will obtain your written authorization for uses and disclosures not otherwise permitted by law, including:
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Certain marketing activities (if required by law)
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Sale of PHI (we do not sell PHI)
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Certain specially protected health information
You may revoke your authorization in writing at any time, except where we have already relied upon it.
7. YOUR RIGHTS
A. Right to Inspect and Copy
You have the right to inspect and obtain a copy of your protected health information maintained in a designated record set.
All requests must be submitted in writing.
We respond within 30 days, with one possible 30-day extension if necessary.
Records are provided in:
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Electronic PDF format
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Paper copy
Records are not released by email, text message, or CD.
We may charge reasonable, cost-based copying fees in accordance with Illinois law (735 ILCS 5/8-2006).
B. Right to Request Amendment
You may request an amendment to your protected health information if you believe it is inaccurate or incomplete.
All requests must be submitted in writing.
If your request is denied, you will receive a written explanation and information about your right to submit a statement of disagreement.
C. Right to Request Restrictions
You may request restrictions on certain uses or disclosures of your PHI.
All requests must be submitted in writing.
We are not required to agree to requested restrictions except where required by law. If we agree, we will comply except in emergency situations.
D. Right to Request Confidential Communication
You may request that we communicate with you by alternative means or at an alternative location.
All requests must be submitted in writing.
We will accommodate reasonable requests in accordance with applicable law.
E. Right to Receive an Accounting of Disclosures
You may request a list of certain disclosures made within the previous six years, excluding disclosures for treatment, payment, and healthcare operations.
Requests must be submitted in writing.
F. Right to Obtain a Paper Copy of This Notice
You may request a paper copy of this Notice at any time.
8. COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with:
International Vein & Skin Institute SC
760 Busse Highway
Park Ridge, IL 60068
📞 (847) 518-9999
You may also file a complaint with the U.S. Department of Health and Human Services.
We will not retaliate against you for filing a complaint.
9. WEBSITE, CONTACT FORMS & ELECTRONIC COMMUNICATION
Information submitted through our website contact forms, text request features, or appointment request tools is used for communication related to your inquiry or appointment scheduling.
Website hosting, form processing, and certain communication tools may be provided by contracted third-party service providers. These vendors operate under written agreements requiring appropriate safeguards of information in accordance with applicable privacy laws.
We do not sell or rent personal information or email lists to outside marketing entities.
Electronic communications submitted through website forms or public text channels may not be encrypted. Patients should avoid submitting detailed medical information, photographs, or sensitive health information through these channels.
You may request removal from email communications at any time by contacting our office.