PRIVACY STATEMENT
Cira Medical Services provides impartial medical, mental health and ergonomic evaluative services (the “Services”) for individuals who have been referred by various third parties. This Privacy Statement outlines the practices of Cira Medical Services relating to the collection, use and disclosure of personal information (including personal health information) obtained through the performance of the Services. In this Privacy Statement, individuals are referred to as the "Examinees" and the third parties who refer the individuals are designated as the "Referring Sources".

Personal Information

For the purpose of this Privacy Statement, “personal information” means information about an identifiable individual, but does not include the name, title or business address or telephone number of an employee of an organization. "Personal health information" means: (a) information concerning physical or mental health; (b) information concerning any health service provided; (c) information concerning the donation of any body part or any bodily substance or information derived from the testing or examination of a body part or bodily substance; (d) information that is collected in the course of providing health services; and (e) information that is collected incidentally to the provision of health services.

Collection of Personal Information

Cira Medical Services collects the following personal information about an Examinee: Contact information (such as name, address, e-mail address and telephone number); Demographic information (such as gender, date of birth and occupation); Medical information (such as medical history and information generated through the conduct of medical examinations and additional diagnostic testing) from: (i) Referring Sources; (ii) Examinees; and (iii) third party service providers who conduct diagnostic testing on behalf of Cira Medical Services. Proof of identity (such as a signature and photo identification).


Use of Personal Information


Cira Medical Services only uses personal information about an Examinee in connection with performing the Services. Specifically, personal information is used to: Conduct evaluations of the specific condition(s) related to an Examinee's injury or illness and any prior or subsequent condition(s) that might affect such injury or illness;

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Communicate with an Examinee for purposes related to the conduct of an evaluation; and
Confirm the identity of an Examinee.
Cira Medical Services does not use personal information about an Examinee for any other
purposes without seeking the Examinee's prior consent.


Sharing of Personal Information


Cira Medical Services may share personal information with third parties engaged to assist it in
carrying out the Services. For example, a limited amount of personal information (name, contact information and language preferences) is shared with translators who assist in the conduct of evaluations of non-English speaking Examinees. Personal information (including personal health information) is shared with medical services providers engaged by Cira Medical Services to perform medical, mental health and ergonomic evaluations. These service providers are prohibited from using personal information for any purpose other than to provide this assistance and are required to protect personal information disclosed by Cira Medical Services in accordance with the general privacy principles described in this Privacy Statement and in accordance with applicable privacy laws.


Personal information about an Examinee (including personal health information generated
through the conduct of medical examinations and additional diagnostic testing) is also shared
with the Referring Source who referred the Examinee.


Disclosure of Personal Information


Cira Medical Services does not disclose personal information for purposes unrelated to the
Services without seeking an Examinee's prior consent.

Cira Medical Services reserves the right to disclose personal information to a third party if a law, regulation, search warrant, subpoena or court order legally requires or authorizes it to do so.Cira Medical Services also reserves the right to disclose and/or transfer personal information to a third party in the event of a proposed or actual purchase, sale, lease, merger, amalgamation or any other type of acquisition, disposal or financing of all or any portion of Cira Medical Services or of any of the business or assets or shares of Cira Medical Services or a division thereof in order for that third party to continue to provide the Services.


Knowledge and Consent


Cira Medical Services only collects personal information about an Examinee with his/her
consent. An Examinee may withdraw consent at any time, subject to legal or contractual
restrictions and reasonable notice. If an Examinee wishes to withdraw his/her consent, he/she
may contact Cira Medical Services (1-800-483-3926). The Examinee will be informed of the
implications of withdrawing consent.


Protection of Personal Information


Cira Medical Services makes commercially reasonable efforts to ensure that personal information is protected against loss and unauthorized access. This protection applies in relation to information stored in both electronic and hard copy form. Access to personal information is restricted to employees or representatives on a need-to-know basis. In addition, Cira Medical Services employs generally accepted information security techniques, such as firewalls and access control procedures to protect personal information against loss and unauthorized access.


Retention of Personal Information


Cira Medical Services retains personal information for as long as necessary to fulfill the purposes for which it was collected and to comply with applicable laws.

Changes to this Privacy Statement


Cira Medical Services reserves the right to modify this Privacy Statement at any time without notice. The Privacy Statement distributed at any time or from time to time shall be deemed to be the Privacy Statement then in effect.


Contacting Us


In the event that an Examinee has any questions about Cira Medical Services' Privacy Statement or has reason to believe that Cira Medical Services may have failed to adhere to this Privacy Statement, the Examinee may contact Keith Edwards, FCILA, CLA, FUEDI-ELAE, Privacy Officer for SCM Insurance and Cira Medical Services at 1-888-204-4726.