Notice of Privacy

This notice describes how medical information about your information or your child may be used and disclosed and how you can access this information. Please read carefully. The following is the privacy policy of Tampa Outpatient Surgical Facility as described in the Health Insurance Portability Accountability Act of 1996 and regulations promulgated there, commonly known as HIPAA. HIPAA requires Tampa Outpatient Surgical Facility by law, to maintain the privacy policy with respect to you or your child health information. We are required by law to abide by the terms of this Privacy Notice.

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 conditions, 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 who may be consulted by staff members.

Payment – Your health information may be used to seek payment from your health plan, from other sources of coverage such as an automobile insurer, or from credit card companies that you may use to pay for services. For example, your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated.

Healthcare Operations – Your health information may be used as necessary to support the day-to-day activities and management of Tampa Outpatient Surgical Facility. For example, information on the services you received may be used to support budgeting and financial reporting, and activities to evaluate and promote quality.

Law Enforcement – 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.

Public Health Reporting – Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable disease to the state’s public health department

Additional Uses of Information

Appointment Reminders – Your health information will be used by our staff to send you or contact you about appointment reminders.

Information about Treatments – Your health information may be used to send you information on the treatment and management of you medical condition that you may find to be of interest. We may also send you information describing other health-related goods and services that we believe may interest you.

Individual Rights – You have certain rights under the federal privacy standards.

You have the right to:

  • Request restriction on the use and disclosure of your protected health information.
  • Receive confidential communications concerning you medical condition and treatment.
  • Inspect and copy you protected health information.
  • Amend or submit corrections to you protected health information.
  • Receive an accounting of how & to whom you protected health information has been disclosed.
  • Receive a printed copy of this notice.

Tampa Outpatient Surgical Facility Duties

  • Maintain the privacy of your protected health information & to provide you with this notice of privacy practices.
  • Abide by the privacy policies and practices that are outlined in this notice.

Right to Revise Privacy Practices – 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 visit. The revised policies and practices will be applied to all protected health information that we maintain.

Requests to Inspect Protected Health Information – As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting the Admitting and Registration Clerk or Facility Privacy Officer.

Internet Privacy Notice – Whenever you visit a website, certain information is also sent to that site by your browser. Types of information that can be gathered include the kind of operating system you’re using, your browser type and browser version, your screen resolution and color depth, and whether you reached the site from a search engine. Personal information, including your email address, is not available when you visit a website, unless you voluntarily submit it.

Of the information we learn about you from your visit to the Tampa Outpatient Surgical Facility website, we store the type of browser you are using, the color depth and resolution of your system, and if you came to us from a search engine. This information is used exclusively to better the performance of this website and better its ability to assist users in finding the information they need.

If you send email to the Tampa Outpatient Surgical Facility (TOSF), we use your return email address only to reply to your email. We do not give, share, sell or transfer any personal information, including email addresses, to a third party.


If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to:

Privacy Officer
Tampa Outpatient Surgical Facility (TOSF)
5013 North Armenia Avenue
Tampa, FL 33603

If you believe that your privacy rights have been violated, you should call the matter to our attention by sending a letter describing the cause of your concern to the same address.

You will not be penalized or otherwise retaliated against for filing a complaint.

Contact Person

The name and address of the person you can contact for further information concerning our privacy practices is:

Facility Administrator
Tampa Outpatient Surgical Facility (TOSF)
5013 North Armenia Avenue
Tampa, FL 33603

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