Each time you visit Dr. Lee a record of your visit is made.  Typically, this record contains information about your visit including your examination, diagnosis, test results and treatments as well as other pertinent healthcare data. This information is often referred to as your health or medical record, serves as a:

  • Basis for planning your care and treatment
  • A means of communication with other health professionals involved in your care
  • A tool that you or your insurance company will use to verify that services billed were actually provided.
  • An education tool for medical health providers
  • A source for medical research
  • A basis for public health officials who might use this information to assess and/or improve state as well as national healthcare standards A source of data for planning and/or marketing
  • A tool that we can reference to ensure the highest quality of care and patient satisfaction
  • Understanding what is in your record and how your health information is used helps you to ensure its accuracy, determine what entities have access to your health information and make and informed decision when authorizing the disclosure of this information to other individuals.


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 and 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.


  Moonhee Lee, M.D.     Allergy & Asthma Center


This notice describes how information about you may be used and disclosed and how you can get access to this information.  Please review it carefully. 
At Dr. Lee’s office we are committed to treating and using protected health information about you responsibly.  This notice describes the personal information we collect and how and when we use or disclose that information.  It also describes your rights as they related to your protected health information. This notice is effective as of April 14, 2003 and applies to all protected health information as defined by federal regulations. 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. Whatever the reason for these revisions, we will provide you with a revised notice on your next office visits. The revised policies and practices will be applied to all protected health information that we maintain.  We will not use or disclose your health information without your authorization, except as described in this notice.  We will also discontinue using or disclosing your health information after we have received a written revocation of the authorization according procedures included in the authorization.

We will use your health information for 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 condition and providing treatment.  For example: results of laboratory tests and procedures will be available in your medical record to all health professionals who may provide treatment or how may be consulted by staff members. We will use your information for payment. Your health plan may request and receive information on dates of service, the services provided and the medical condition being treated in order to pay for the service rendered to you. We will use your information for regular health operations. Your health information may be used as necessary to support the day-to-day activities and management of Dr. Lee’s office.  For example:  information on the services you received may be used to support budgeting and financial reporting and activities to evaluate and promote quality.

Business Associates

In some instances, we have contracted separate entities to provide services for us.  These “associates” require your health information in order to accomplish the tasks that we ask them to provide.  Some examples of these “business associates” might be a billing service, collection agency, answering services and computer software/hardware providers.
Communication with family

Due to the nature of our field. We will use our best judgment when disclosing health information to a family member, other relatives, or any other person that is involved in your care or that you have authorized to receive this information.  Please inform the practice when you do not wish a family member or other individual to have authorization to receive your information. Research/Teaching/Training
We may use your information for the purpose of research, teaching and training. Healthcare Oversight
Federal law requires us to release your information to an appropriate health oversight agency, public health authority or attorney or other federal/state appointee if there are circumstances that require us to do so. Public health reporting. Your health information may be disclosed to law enforcement agencies, without your permission, to support government audits and inspections, to facilitate law-enforcement investigations, and to comply with government mandated reporting. Appointment reminders
The practice may use your information to remind you about upcoming appointments. Typically, appointment reminders are sent by mail in a closed envelope or a brief, non-specific message may be left on your answering machine.  If you don’t approve of these methods, or if you prefer alternative methods (i.e., email), please inform the practice. Other uses and disclosures. 
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.   FOR MORE INFORMATION OR TO REPORT A PROBLEM If you have complaints, questions or would like additional information regarding this notice or the privacy practices of Dr. Lee, please contact:  Tanya Burdett, R.N. 3939 W. Green Oaks Blvd Suite 210
Arlington, TX  76016 817-457-3939
If you believe that your privacy rights have been violated, please contact the aforementioned practice Privacy Official or you may file a complaint with the Office for Civil Rights, U.S. Department of Health and Human Services.  There will be no retaliation for filing a complaint with either the practice’s Privacy Official or with the Office for Civil Rights. 
The address for the Office for Civil Rights is listed below: OFFICE FOR CIVIL RIGHTS U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Room 509F, HHH Building Washington, D.C.  20201              


Dr Lee is required to:      

  • Maintain the privacy of your health information       
  • Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
  • Abide by the terms of this notice       
  • Notify you if we are unable to agree to a requested restriction     
  •   Accommodate reasonable requests you may have regarding communication of health information via alternative means and locations.