JENATTE CLARK DERMATOLOGY

PRIVACY POLICY & ELECTRONIC COMMUNICATION CONSENT

Patient Name: _______________________________________________

Date of Birth: ___________________________

Jenatte Clark Dermatology is committed to protecting the privacy and confidentiality of our patients and website visitors. This Privacy Policy explains how we collect, use, disclose, and safeguard your personal information when you visit our website or communicate with our office.

INFORMATION WE COLLECT

We may collect personal information, including:

  • Name

  • Date of birth

  • Telephone number

  • Email address

  • Mailing address

  • Insurance information

  • Medical information you voluntarily provide

  • Appointment requests

  • Waivers and consent forms submitted through eForms

  • Mobile phone numbers used for telephone or text message communications

HOW WE USE YOUR INFORMATION

We use your information to:

  • Schedule and confirm appointments

  • Respond to questions and requests

  • Communicate regarding your medical care

  • Send appointment reminders

  • Notify you of office closures or scheduling changes

  • Communicate regarding prescriptions, laboratory results, pathology results, and billing, when appropriate

  • Improve our services and patient experience

  • Meet legal and regulatory requirements

HIPAA COMPLIANCE

Jenatte Clark Dermatology complies with the Health Insurance Portability and Accountability Act (HIPAA) and applicable federal and Washington State privacy laws governing protected health information (PHI).

We maintain administrative, technical, and physical safeguards designed to protect the confidentiality, integrity, and security of your protected health information.

ELECTRONIC COMMUNICATION BY TEXT MESSAGING

Our SMS Text Messaging Number: (509) 654-9810

SMS and Mobile Information Privacy

We do not sell, rent, or share mobile phone numbers or SMS opt-in information with third parties or affiliates for their own marketing or promotional purposes. SMS consent and mobile information will not be used for unrelated marketing.

We may disclose information to service providers that process information solely on our behalf to provide requested healthcare communications and related services. These service providers are not permitted to use SMS consent information or mobile phone numbers for their own marketing or promotional purposes.

We may also disclose information when required by law or as necessary for treatment, payment, healthcare operations, security, or compliance with applicable legal requirements.

If you have any questions regarding this Privacy Policy, you may contact our office at (509) 654-9810 and we would be happy to answer your questions.

Text messages are intended primarily for:

  • Appointment reminders

  • Appointment confirmations

  • Scheduling requests

  • Office announcements

  • Billing notifications

  • General patient service communications

  • Prescription refill requests

By voluntarily providing your mobile phone number, you consent to receive text messages from Jenatte Clark Dermatology.

  • Consent to receive text messages is not a condition of receiving healthcare treatment.

  • Message and data rates may apply.

  • Message frequency may vary.

  • Users can reply STOP to opt out and HELP for assistance.

SECURITY

Although no method of electronic transmission is completely secure, we implement commercially reasonable safeguards designed to protect your information from unauthorized access, disclosure, alteration, or destruction.

CHANGES TO THIS POLICY

We may update this Privacy Policy periodically. Any revisions will become effective upon posting to this website.

CONTACT US

If you have questions regarding this Privacy Policy or your personal information, please contact:

Jenatte Clark Dermatology
Phone: (509) 654-9810
Normal Business Hours: Monday–Thursday, 8:00 AM–5:00 PM

PATIENT ACKNOWLEDGMENT & CONSENT

By signing below, I acknowledge that I have read and understand the Jenatte Clark Dermatology Privacy Policy & Electronic Communication Consent. I understand how my personal information may be collected, used, and disclosed as described above.

I voluntarily provide my mobile telephone number and consent to receive text messages from Jenatte Clark Dermatology for the purposes described in this form. I understand that text messaging consent is voluntary and is not a condition of receiving healthcare treatment.

I understand that I may opt out of text messaging at any time by replying STOP to a text message.

I understand that message and data rates may apply and that message frequency may vary.

Patient Signature: _______________________________________________

Date: ___________________________

Patient Printed Name: ___________________________________________

Date of Birth: ___________________________