Notice of Privacy Practices

How Arlington ER may use and disclose your health information, and the rights you have over it.

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.

Effective Date: 15th, August, 2026

About This Notice

Arlington ER is committed to protecting the privacy of your health information. Federal law requires us to maintain the privacy of that information, to give you this Notice explaining our legal duties and privacy practices, and to follow the terms of the Notice currently in effect.

This Notice applies to all records of your care created or held at our facility at 1607 S Bowen Rd, Pantego, TX 76013.

We maintain electronic health records and may transmit your protected health information electronically to other healthcare providers, laboratories, insurance companies, and other entities as described in this Notice.

We may change this Notice at any time. Any revised Notice will apply to information we already hold as well as information we receive in future. The current version is always available at our facility and on this website.

What Is Protected Health Information?

Protected Health Information, or PHI, is any information that identifies you and relates to your health condition, your treatment, or payment for your care. It includes your medical history, examination findings, imaging and laboratory results, diagnoses, treatment plans, and billing records.

How We Use and Disclose Your Information

Treatment

We share relevant information with the physicians, nurses, technicians, and other clinical staff involved in your care. When your condition requires specialized care or admission, we coordinate with hospitals, specialists, and transferring services so that your care continues without interruption.

Payment

We use your information to bill for the services you receive and to work with your health plan to resolve coverage and billing questions. This may include sharing information with your insurer to confirm eligibility or to obtain payment.

Healthcare Operations

Your records support quality improvement, clinical review, staff training, audits, licensing, and accreditation activities that help us run the facility and improve the care we provide.

Disclosures We May Make Without Your Permission

Federal and state law permit or require us to disclose your health information without your authorization in the following circumstances:

  • Legal compliance: Court orders, subpoenas, and other requirements of federal, state, or local law
  • Public health activities: Disease prevention and control, injury reporting, and tracking of adverse reactions
  • Abuse or neglect: Reports to the appropriate government agencies
  • Health oversight: Audits, investigations, inspections, and licensure activities
  • Law enforcement: Victim identification, reports of deaths, and other lawful requests
  • Preventing serious harm: To address a serious and imminent threat to the health or safety of a person or the public
  • Organ and tissue donation: To procurement organizations and eye banks
  • Death investigations: To medical examiners, coroners, and funeral directors
  • Workers’ compensation: For claims relating to work-related injury or illness
  • Military and veterans: As required by armed forces command authorities
  • Specialized government functions: National security, intelligence, and protective services
  • Correctional facilities: Where required for the health and safety of an inmate or others

Uses That Require Your Written Permission

Any use or disclosure not described in this Notice will be made only with your written authorization. You may revoke that authorization at any time by written request, except where we have already acted in reliance on it.

Written authorization is always required for psychotherapy notes, for marketing communications for which we receive payment, and for any sale of your health information.

Your Rights

  • Access your records. You may request a copy of your health and billing records in writing. We will respond within 30 days. A reasonable, cost-based fee may apply.
  • Request a correction. You may ask us to amend information you believe is inaccurate or incomplete. We may decline, and will explain why in writing if we do.
  • Request restrictions. You may ask us to limit how we use or disclose your information. We are not required to agree, except that we must honor a request to withhold information from your health plan for services you have paid for in full out of pocket.
  • Confidential communication. You may ask us to contact you in a particular way or at a particular address.
  • Accounting of disclosures. You may request a list of certain disclosures we have made in the previous six years. The first request in any twelve-month period is free.
  • Paper copy of this Notice. You may request a printed copy at any time, even if you agreed to receive it electronically.
  • Breach notification. We will notify you if a breach occurs that compromises the privacy or security of your unsecured health information.
  • Choose someone to act for you. If you have given someone medical power of attorney, or if someone is your legal guardian, that person can exercise these rights on your behalf.

Our Responsibilities

Arlington ER is required by law to maintain the privacy and security of your protected health information, to give you notice of our legal duties and privacy practices, to follow the terms of the Notice currently in effect, and to notify you promptly if a breach occurs that may have compromised the privacy or security of your information.

We will not use or share your information other than as described in this Notice unless you tell us in writing that we may.

How to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with us using the contact details below, or with the U.S. Department of Health and Human Services, Office for Civil Rights.

Complaints to the Office for Civil Rights may be sent to 200 Independence Avenue S.W., Washington, D.C. 20201, by calling 1-877-696-6775, or online at hhs.gov/ocr/privacy/hipaa/complaints.

You will not be penalized, and your care will not be affected, for filing a complaint.

Contact Us

Privacy Officer
Arlington ER | 24/7 Emergency Room
1607 S Bowen Rd, Pantego, TX 76013
Phone: 817-973-7406
Email: info@arlingtoner.com

Arlington ER is licensed by the Texas Department of State Health Services as a Freestanding Emergency Medical Care Facility, License No. 160615.