Downey Plastic Surgery 

Medical Records Request


Downey Plastic Surgery patients 4/2006-5/2019


Proliance Surgeons patients 5/2019-9/2021


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Downey Plastic Surgery expects to maintain your trust and confidentiality from the initial call to your graduation from needing our services. Our office complies with all features of Health Insurance Portability and Accountability Act of 1996 (HIPAA). The links below will elaborate on the details of the various policies by which we abide.



Your Medical Privacy


This office is dedicated to protecting the privacy rights of our patients and the confidentiality of the information we receive from our patients. All of our employees and business associates are required to protect the confidentiality of your health information. We may amend this Notice of Privacy Practices from time to time. Should such amendments occur, we will distribute our amended notice and will make the revised notice otherwise available to our patients.

Uses and Disclosures of Personal Healthcare Information

We use and disclose the information we collect from you only as allowed by law, and for the following types of uses:

1. Treatment: We will use and disclose health information in order to provide the highest level of quality care and to ensure continuity of care between our office and your other health care providers, as necessary and appropriate.

2. Payment: We will use and disclose health information in order to collect payment for the services and treatment we provide. It may be necessary to provide such information to third parties such as insurance companies or other third-party payors.

3. Health Care Operations: We may use health information in order to manage the administrative aspects of our office. This may include using health information in order to measure the quality of our services or to provide education to staff or other health care providers.

4. Personal Representatives/Family Members: We may disclose health information to a patient’s personal representative or family members unless the patient notifies us that he or she objects to such disclosures. Such disclosures will be limited to information relating to general condition.

5. Appointment Reminders/Treatment Alternatives: We may use health information to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to patients.

6. Other Uses: We may use and disclose health information for other purposes upon obtaining a patient’s written authorization for such uses and disclosures.

Patient Rights

Patients have the following rights with respect to protected health information:

1. Right to Request Restrictions: Patients have the right to request that we restrict uses or disclosures of protected health information regarding the patient to carry out treatment, payment, or health care operations, or uses for which Patients have the opportunity to agree or object. This office is not required to agree to a requested restriction.

2. Right to Receive Confidential Communications of Protected Health Information: Patients may request that they receive communications of protected health information from us by alternative means or at alternative locations. We will accommodate all such reasonable requests submitted by patients in writing. We may condition the provision of a reasonable accommodation on, when appropriate, information as to how payment, if any, will be handled.

3. Right to Inspect and Obtain a Copy of Protected Health Information: Patients may request, in writing, access to inspect or obtain a copy of their health care information maintained by this office as medical or billing records, or any other information that is used by this office, in whole or in part, to make decisions about Patients. Such requests may be denied in limited situations.

4. Right to Amend Protected Health Information: Patients have the right to request, in writing, that we amend their protected information maintained by this office as medical or billing records, or any other information that is used by this office, in whole or in part, to make decisions about Patients. For all such requests, Patients must provide a reason to support the request. Such requests may be denied in limited situations.

5. Right to Receive Accounting of Disclosures of Protected Health Information: Patients have the right to request an accounting of disclosures of Protected Health Information. We are not required to account for such disclosures in limited situations. Otherwise, we will respond to all such requests by providing an accounting of all disclosures made in the six years prior to the request. We will provide request forms as requested.

6. Notice of Privacy Practices: Patients, upon request, have the right to obtain a paper copy of this Notice of Privacy Practices, including patients who have otherwise agreed to receive this Notice of Privacy Practices in electronic form.

Our Duties

Downey Plastic Surgery has the following duties with respect to Patients’ Protected Health Information:

1. Duty to Maintain Privacy: We are required by law to maintain the privacy of Patients’ Protected Health Information and to provide Patients with this Notice of Privacy Practices that describes our legal duties with respect to Protected Health Information.

2. Compliance with Terms of Notice: We are required to abide by the terms of our Notice of Privacy Practices currently in effect.

3. Changes in Notice of Privacy Practices: We reserve the right to amend this Notice of Privacy Practices with respect to all Protected Health Information we maintain. Should we amend this Notice of Privacy Practices, we will provide Patients with the revised notice and we will post and make the revised notice otherwise available to Patients.

4. Complaints: Patients may complain to us and to the Secretary of Health and Human Services if they believe their privacy rights have been violated. Patients may file complaints with this office by submitting the complaint in writing to our office, Attention: Privacy Officer. We will not retaliate against Patients submitting complaints pursuant to this Notice of Privacy Practices.

Web Site Privacy Statement

Downey Plastic Surgery respects and protects the privacy of those who visit or use our Web site; we want you to know how your information is used. To demonstrate our commitment to fair information practices, we have adopted privacy guidelines accepted by industry leaders. Our on-line privacy policy protects the information that you share with us over the Internet. We employ industry-recognized safeguards to protect the personally identifiable information that you have provided to us against loss, misuse, and unauthorized alteration.

When using our site you may get information or communicate with us. To gain a better understanding of people like you who are interested in our work, we may request information from you when you visit our Web site. Excluding financial planning information, this information is never tied to any personally identifiable information.

We welcome your questions or comments about our on-line privacy policy and practices regarding information that is submitted to us. You may contact us at

What Information is Collected and How is it Used?


We collect contact information such as name, mailing address, email address, and phone number. We use this information to contact you in the case that you have specified via the “appointments form” on our web site that you are interested in making an initial consultation at our office.

Contact Us

We use email links located on the “contact us” page and other areas of the site to allow you to contact us directly with any questions or comments you may have. We read every message sent in and try to reply promptly to every one. This information is used to respond directly to your questions or comments. We may also file your comments to improve the site and program, or review and discard the information. Your personal information is only shared with third parties with your explicit permission.

Logged Files and Cookies

For each visitor to our Web site, our Web server automatically recognizes only the visitor’s IP address (e-mail addresses are not automatically recognized by our server). We use your IP address to help diagnose problems with our server and to administer our Web site. Your IP address is used to gather broad demographic information and is then discarded.

Security of Collected Information

No information gathered from users is shared. We maintain strict physical, electronic, and administrative safeguards to protect your personal information from unauthorized or inappropriate access.

Links to Other Sites

This site contains links to other sites. Downey Plastic Surgery is not responsible for the privacy practices or the content of such Web sites.