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.
Who follows this notice. This notice applies to PJM Clinic and everyone who works or volunteers there, including our clinicians and staff, whether they are employees or independent contractors.
Project New Gen LLC, doing business as PJM Clinic · 4444 W Northern Ave, Suite B1, Glendale, AZ 85301
Effective date: October 11, 2026
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record. You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record. You can ask us to correct health information about you that you think is incorrect or incomplete. We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications. You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree, and we may say “no” if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information. You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
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 your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
How to make a request. To use any of these rights, send a written request to our Privacy Officer (contact information below). A request form is available at the front desk, and our staff can help you fill it out. We will respond within the time the law requires.
File a complaint if you feel your rights are violated. You can complain if you feel we have violated your rights by contacting us using the information at the end of this notice. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to: share information with your family, close friends, or others involved in your care; share information in a disaster relief situation. If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission: marketing purposes; sale of your information; most sharing of psychotherapy notes.
How do we typically use or share your health information? We typically use or share your health information in the following ways.
Treat you. We can use your health information and share it with other professionals who are treating you. Example: A doctor treating you asks another doctor about your overall health condition.
Run our organization. We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services.
Lab tests and referrals. We can share your health information with outside laboratories that process your tests (for example, Sonora Quest Laboratories) and with specialists or other providers we refer you to, so they can care for you. Example: we send a lab order with the information the lab needs to run and report your test.
Appointment reminders and follow-up. We can use your contact information to remind you of appointments, follow up after a visit, or tell you about our services, using the phone number, text number, mail, or email you give us. You can ask us to use a different method or to stop.
Business associates. Some services are provided for us by outside companies, such as billing, electronic health records, IT, and email providers. We can share your information with them so they can do that work, but only under written agreements that require them to protect it.
Bill for your services. We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services.
How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Extra protections under Arizona law. Arizona gives some information extra protection, such as information about HIV/AIDS and other communicable diseases, genetic testing, and certain mental health records. We will share that information only as Arizona and federal law allow, and we will ask for your written permission when the law requires it.
Health information exchange. PJM Clinic does not currently share records through a health information exchange. If we join one (such as Arizona’s statewide exchange), we will update this notice and explain how you can opt out.
Reproductive health care information. We will follow federal and Arizona law that applies to requests for health information related to reproductive health care, including any requirement to obtain a signed attestation before disclosure for certain purposes.
Substance use disorder records. If we receive or keep records protected by federal confidentiality rules for substance use disorder treatment (42 C.F.R. Part 2), we will use and share them only as those rules allow.
For more information see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, posted in our waiting area, and on our website.
Questions, requests, or complaints about this notice: Privacy Officer, c/o PJM Clinic, 4444 W Northern Ave, Suite B1, Glendale, AZ 85301 · (623) 233-0651 · pjmclinic@pjmclinic.com
This notice applies to PJM Clinic. Our Website Privacy Policy separately describes information collected through this website.