Phone: 407.333.4300

Longwood | Lake Mary | Dr. Phillips | Daytona

Confidentiality Statement

Protecting the Privacy of Patients’ Health Information


1. The privacy of all medical records and other individually identifiable health information must be protected at all times. Information relating to a patient’s health care history, diagnosis, condition, treatment, or evaluation shall be considered individually identifiable health information. Confidentiality of this health information must be maintained at all times, and may only be disclosed with the express written consent of the patient.

2. Non-individually identifiable health information, (e.g. health information that cannot be linked to a specific patient) is not included within the definition of protected health information.


1. An individual’s health information can be used for health purposes only.

2. Protect individually identifiable health information. Goldfingers Aesthetics shall not publish or otherwise make generally available any information or data that identifies a patient for purposes other than treatment, payment or other health care operations, without his or her express written consent. This does not restrict the internal use of such information or data that is required in the performance of the scope of work that Premier Medical Clinic has been engaged to perform for a client. Premier Medical Clinic also maintains physical, electronic, and procedural safeguards to protect individually identifiable health information. Premier Medical Clinic is always assessing those safeguards and shall make ongoing improvements to maintain and enhance our level of security for individually identifiable health information.

3. Ensure that health information is not used for non-health purposes. Patient information can be used or disclosed only for purposes of health care treatment, payment, and operations. Health information cannot be used for purposes not related to health care without explicit authorization from the patient. For example, Goldfingers Aesthetics may not access the personal health information obtained by a Premier Medical Clinic affiliate for any purpose other than to perform the services, for which we were engaged, unless Goldfingers Aesthetics first obtains the explicit authorization of the patient.

4. Maintain health information in a manner to protect confidentiality. All individually identifiable health information shall be maintained by Goldfingers Aesthetics in a confidential manner that prevents unauthorized or inadvertent disclosure to third parties. For example, Goldfingers Aesthetics may share confidential information with a third party under contract or affiliated with Goldfingers Aesthetics for the same purpose of performing the services for which we were engaged, provided that the information shall remain confidential at all times and shall be shared with only those persons that have authority to receive such information.


There are serious penalties for violation of the confidentiality of health information. Please be advised of the following:

1. State Penalties. Various state laws impose criminal and civil penalties on individuals who misuse or disclose individually identifiable health information without explicit consent by the patient.

2. Federal Penalties. HIPAA (Health Insurance Portability and Accountability Act) is a piece of federal legislation that directly addresses the protection of confidential health information. HIPAA provides for civil money penalties up to $25,000 per person, per year for violations of patient confidentiality. HIPAA also provides for federal criminal penalties.

3. Goldfingers Aesthetics Penalties. Any employee who violates the privacy and confidentiality of patient health information, through disclosure or otherwise, may be subject to disciplinary action, including termination of his or her employment with Goldfingers Aesthetics