NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

The effective date of this Notice is August 01, 2026.

To appropriately treat you and receive payment for the services we provide, we need to obtain information from you, including your full name, address, insurance information, family medical history, current medical history, and current medical condition. We will use and disclose this information, as well as other information we collect, in the ways described below.

To help you understand how we may use and disclose your information, we have organized the different uses and disclosures into categories and provided examples. All uses and disclosures of your information will fall within one of the categories listed below; however, we cannot list every possible use or disclosure within each category.

We may use and disclose your health information for treatment, payment, and health care operations.

Treatment. We may use and disclose your information to provide you with medical treatment and services. Your information may be disclosed to individuals or facilities providing care to you. These individuals and facilities need your information to provide care and coordinate services, such as prescriptions, laboratory testing, diagnostic imaging, referrals to other healthcare providers, surgical services, and x-rays.
Payment. We may use and disclose your information to receive payment for the services and treatment provided to you. We use your information to create a bill and disclose your information when we submit claims to your insurance company, bill you directly, or communicate with another responsible party regarding payment. The individual or entity paying the bill may request additional information to determine whether the bill is covered by your insurance. We may also tell your health plan about a treatment you are going to receive to obtain prior authorization or determine whether your health plan will cover the treatment.
Health Care Operations. We may use and disclose your information for health care operations. Health care operations include review of the care you receive for quality assessment and improvement, staff education and training, credentialing, licensing, compliance activities, auditing, risk management, business planning, customer service, and other administrative functions.

We may disclose and use your health information as permitted by law for the following purposes:

Appointment Reminders and Health Care Communications. We may contact you regarding appointments, appointment reminders, billing statements, payment reminders, surgery scheduling, prescription information, test results, patient portal messages, and other healthcare-related communications. We may communicate with you by telephone, voicemail, text message, email, patient portal, or mail. You may request in writing that we send communications to a confidential or alternative address or by an alternative method.
Treatment Alternatives. We may provide you with information about treatment alternatives and other health-related benefits and services that may be of interest to you.

We may also disclose your health information to outside entities without your consent or authorization in the following circumstances:

Required by Law. We disclose information as required by law. For example, we may be required to report certain injuries, abuse or neglect, communicable diseases, or comply with court orders and other legal requirements.
Public Health Purposes. We disclose information to public health agencies as required by law for preventing or controlling disease, injury, or disability. Examples include reporting communicable or infectious diseases and other conditions required by law.
To Prevent a Serious Threat to Health or Safety. We may disclose information about you to law enforcement or other appropriate individuals when necessary to prevent or lessen a serious threat to your health or safety or the health or safety of another individual or the public.
Research. Your information may be used or disclosed to researchers for research approved by an Institutional Review Board (IRB) or other privacy board, as permitted by law.
Health Oversight Activities. Your health information may be disclosed to governmental agencies for investigations, audits, inspections, licensing, accreditation, and other oversight activities authorized by law.
Judicial and Administrative Proceedings. We may disclose your health information in response to a court order or as otherwise permitted or required during a judicial or administrative proceeding.
Law Enforcement Activities. We may disclose your information to law enforcement officials as required by law or in response to a court order, warrant, subpoena, summons, or other lawful process.
Emergency Circumstances. We may disclose your health information when necessary to provide emergency treatment or when required to respond to an emergency situation.
Deceased Individuals. We may disclose information to coroners, medical examiners, or funeral directors to identify a deceased person, determine the cause of death, or carry out their authorized duties.
Military and Veterans. If you are a member of the armed forces, we may release information about you as required by military command authorities. We may also release information about foreign military personnel to the appropriate foreign military authority.
Inmates. If you are an inmate of a correctional institution or are in the custody of a law enforcement official, we may disclose your health information if necessary (1) for the institution to provide you with health care; (2) to protect your health or safety or the health or safety of others; or (3) for the safety and security of the correctional institution.
Protective Services for the President and Others. We may disclose your health information to authorized federal officials for the protection of the President, other authorized persons, or foreign heads of state, or to conduct special investigations as authorized by law.
Organ and Tissue Donation. If you are an organ donor, we may release your medical information to organizations involved in organ, eye, or tissue procurement, banking, or transplantation, as necessary to facilitate donation and transplantation.
Workers’ Compensation. We may release medical information about you for workers’ compensation or similar programs that provide benefits for work-related injuries or illnesses.
National Security and Intelligence Activities. We may release information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

We will give you the opportunity to object to the following uses and disclosures of your information:

Notification. We may share information with your family members, relatives, close friends, or other individuals involved in your care or payment for your care if the information is relevant to their involvement.
Disaster Relief. We may disclose information about you to public or private agencies for disaster relief purposes.

Except as described above, we will obtain your written authorization before using or disclosing your information for any other purpose. Specifically, written authorization is required before the use or disclosure of your information for:

Psychotherapy Notes. We will not use or disclose your psychotherapy notes without your written authorization except as specifically permitted or required by law.
Marketing. We will not use or disclose your information for marketing purposes, other than face-to-face communications with you or promotional gifts of nominal value, without your written authorization.
Sale of Protected Health Information. We will not sell your Protected Health Information without your written authorization, except as otherwise permitted by law.

Where a disclosure is made under your written authorization, you have the right to revoke the authorization at any time. Revocation of an authorization must be in writing. The revocation becomes effective on the date we receive it and does not affect any prior uses or disclosures made in reliance on your authorization.

If state or federal law provides additional restrictions or protections regarding your health information, we will comply with the more restrictive applicable law.

Your Rights

Right to Request Restrictions. You have the right to request restrictions on how your health information is used or disclosed. If you wish to request a restriction, contact our Privacy Officer. We are required to agree to a request to restrict disclosure of information to your health plan for payment or healthcare operations when you or another person on your behalf pay for the service in full out-of-pocket, unless disclosure is otherwise required by law. We are not otherwise required to agree to requested restrictions.
Right to Request Confidential Communications. You have the right to request that we communicate with you at an alternative address, telephone number, email address, or by another reasonable method. To make this request, contact our Privacy Officer.
Right to Inspect and Obtain a Copy of Your Medical Record. You have the right to inspect and obtain a copy of your medical record. Requests must be made in writing. Contact our Privacy Officer to obtain the appropriate request form.
Right to Request an Amendment. If you believe the information we maintain about you is incorrect or incomplete, you may request that we amend your medical record. Requests must be made in writing. Contact our Privacy Officer to obtain the appropriate request form.
Right to Receive an Accounting of Disclosures. You have the right to receive an accounting of certain disclosures of your health information made for purposes other than treatment, payment, or healthcare operations. You are entitled to one (1) free accounting during any twelve (12) month period. Additional requests within the same twelve (12) month period may be subject to a reasonable fee. The accounting will include disclosures as required by applicable law.
Right to Receive a Copy of This Notice. You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive it electronically.

Our Duties

We are required by law to maintain the privacy of your Protected Health Information (PHI) and to provide you with this Notice of our legal duties and privacy practices regarding your health information.
We are required to notify you if there is a breach of your unsecured Protected Health Information.
We are required to follow the terms of the Notice currently in effect.
We reserve the right to change the terms of this Notice at any time. Any revised Notice will apply to all Protected Health Information that we maintain. The current version of our Notice will be available in our offices and on our website, and a copy will be provided to you upon request.