All services provided are strictly confidential. No information is released without
                  your permission. Exceptions, however, may occur in extreme, life-threatening emergencies
                  or when required by law. Examples of these situations may be:
               
               
               
                  
                  - Local medical associates – Some of our services, such as laboratory tests, are provided
                     through contracts with medical associates. Since these services are contracted, we
                     may disclose your health information to them so they may perform the job we have asked
                     them to do and bill you or your insurance coverage for the services provided. We require
                     that our medical associates protect your health information.
                  
 
                  
                  - Child abuse – If a provider at Health Services has reasonable cause to believe that
                     a minor child is suffering physical or emotional injury resulting from abuse inflicted
                     upon him or her which causes harm or substantial risk of harm to the child’s health
                     or welfare (including sexual abuse), or from neglect (including malnutrition), Health
                     Services must immediately report such conditions to the Massachusetts Department of
                     Social Services.
                  
 
                  
                  - Adult and Domestic abuse – If a provider at Health Services has reasonable cause to
                     believe that an elderly person (age 60 or older) is suffering from or has died as
                     a result of abuse, Health Services must immediately make a report to the Massachusetts
                     Department of Elder Affairs.
                  
 
                  
                  - Public Health – We may use or disclose your health information to the Massachusetts
                     Public Health Department to collect information for the purpose of controlling communicable
                     disease.
                  
 
                  
                  - Court ordered – We may use or disclose your health information in the event of a court
                     order.
                  
 
                  
                  - Law Enforcement officials – We may disclose your health information to law enforcement
                     officials as required by law or in compliance with a court order. We may also disclose
                     limited health information to police or law enforcement officials for identification
                     and location purposes, and to assist in criminal investigations.
                  
 
                  
                  - Serious threat to health or safety – If you communicate to a Health Services provider
                     an explicit threat to kill or inflict serious bodily injury upon an individual, Health
                     Services must take reasonable precautions, which may include warning potential victims,
                     notifying law enforcement, or possibly arranging for your hospitalization. If you
                     present as a danger to yourself and refuse appropriate treatment, we have a reasonable
                     basis to believe that you can be committed to a hospital; we must seek said commitment
                     and may contact members of your family or other individuals if it would assist in
                     protecting you.