Users Manual

206
Appendix
Our Duties
Generally: We are required by law to maintain the privacy and security of your Medical
Information and to provide you with notice of our legal duties and privacy practices with
respect to Medical Information, and to notify you if there is a breach resulting in disclosure of
your unsecured Medical Information.
Revisions and Modications: We may change this HIPAA Privacy Notice at any time. Before
we make a signicant change in our policies, we will change this HIPAA Privacy Notice and
post our new notice (the “Revised HIPAA Privacy Notice”). We are required to abide by the
terms of this HIPAA Privacy Notice until a Revised HIPAA Privacy Notice becomes eective.
e Revised HIPAA Privacy Notice will be eective for all Medical Information that we
maintain as of the eective date of the Revised HIPAA Privacy Notice even if we collected or
received the Medical Information prior to the eective date of the Revised HIPAA Privacy
Notice. e current HIPAA Privacy Notice is posted on our Website at www.myomnipod.com.
If you would like to request a paper copy of this HIPAA Privacy Notice, please download our
Request Form at
https://www.myomnipod.com/images/upload/HIPAA_Privacy_Notice_Request_Form.pdf
and follow the directions included on that form.
What To Do If You Have a Problem or Question
If you have any further questions relating to this HIPAA Privacy Notice or if you have a
problem or complaint, please contact us in writing or by phone at:
Insulet Corporation
Attn: Privacy Ocer
100 Nagog Park
Acton, MA 01720
[phone]
Furthermore, if you believe that Insulet has violated your privacy rights with respect to your
Medical Information, you have the right to le a complaint in writing with our Privacy Ocer
or with the Secretary of Health and Human Services at 200 Independence Avenue, S.W.
Washington, D.C. 20201 or by calling [phone]. Insulet will not retaliate against you for
ling such a complaint.
Eective Date: August 11, 2004
Revision Dates: April 1, 2009, September 20, 2013, April 22, 2014, September 2, 2014, and
June 1, 2019