Clinical Privacy Notice

Notice of Privacy Practices

Integrative Lifestyle Medicine PLLC

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.

Our commitment

Integrative Lifestyle Medicine PLLC is required by law to maintain the privacy of your protected health information, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.

How we may use and disclose your health information

Treatment. We use your health information to provide your care and may share it with other providers involved in your treatment.

Payment. We may use and disclose your information to bill and collect payment for services, including to your insurer.

Health care operations. We may use your information to run our practice — quality review, training, scheduling and administration.

Appointment reminders and care communications. We may contact you by the methods you have authorized to remind you of appointments and to tell you about treatment options or services related to your care.

People involved in your care. We may share information with a family member or other person you have identified as involved in your care or the payment for it.

As required or permitted by law. Including public health activities, health oversight, judicial and administrative proceedings, law enforcement, to avert a serious threat to health or safety, and as otherwise required by federal or state law.

Business associates. We may share information with service providers that perform functions on our behalf, under written agreements requiring them to protect it.

Uses and disclosures that require your written authorization

Most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and any sale of your health information require your written authorization. Other uses and disclosures not described in this notice will be made only with your written authorization. You may revoke an authorization at any time in writing, except to the extent we have already acted on it.

Your rights

To inspect and obtain a copy of your health information, including an electronic copy where we maintain it electronically.
To request an amendment if you believe information is incorrect or incomplete.
To an accounting of disclosures we have made, other than for treatment, payment and operations and certain other exceptions.
To request restrictions on how we use or disclose your information. We are not required to agree, except that we must agree to a request to restrict disclosure to a health plan where you have paid for the service in full out of pocket.
To request confidential communications by a particular method or at a particular location.
To be notified following a breach of unsecured protected health information.
To a paper copy of this notice at any time, even if you have agreed to receive it electronically.

Changes to this notice

We reserve the right to change this notice and to make the revised notice effective for information we already hold as well as information we receive in the future. The current notice is available at our office and on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with Integrative Lifestyle Medicine PLLC, or with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

Contact

For questions about this notice or to exercise your rights, contact Integrative Lifestyle Medicine PLLC.

Our online forms and text message program are provided through a technology platform whose Privacy Policy and Terms of Service also apply to your use of them.

Integrative Lifestyle Medicine PLLC • Notice of Privacy Practices