For all other types of uses and disclosures not described in this notice, LifeSong Inc. will use or disclose clinical information only with a written authorization signed by you that states who may receive the information, what information is to be shared, the purpose of the use or disclosure and an expiration for the authorization. Written authorizations are always required for use and disclosure of psychotherapy notes and for certain marketing purposes.
NOTE: If you cannot give permission due to an emergency, LifeSong Inc. may release clinical information in your best interest. We must tell you as soon as possible after releasing the information.
You may revoke your authorization at any time. If you revoke your authorization in writing, we will no longer use or disclose your clinical information for the reasons stated in your authorization. We cannot, however, take back disclosures we made before you revoked and we must retain clinical information that indicates the services we have provided to you.