this notice. if you request copies, we will charge you .50 cents for each page, $10.00 per hour for staff time to locate and copy your health information and postage if you want the copies mailed to you. if you request an alternative format, we will charge a cost-based fee for providing you health information in that format. if you prefer, we will prepare a summary or an explanation of your health information for a fee. contact us using the information listed at the end of this notice for a full explanation of our fee structure.
you have the right to receive a list of instance in which we or our 