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.

1. Our Commitment to Your Health Information We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at our clinic. We need this record to provide you with quality care and to comply with certain legal requirements.

2. How We May Use and Disclose Protected Health Information (PHI) For Treatment: We may use PHI to provide you with medical treatment or services, such as IV hydration therapy, weight loss consultations, or nutritional counseling. For Payment: We may use and disclose PHI so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company, or a third party. For Health Care Operations: We may use PHI for clinic operations, such as reviewing our treatment and services and evaluating the performance of our staff.

3. Your Health Information Rights Although your health record is the physical property of the medical facility that compiled it, you have the right to: inspect and copy your record, request an amendment to your record, obtain an accounting of disclosures, request communications of your health information by alternative means, and request a restriction on certain uses and disclosures of your information.

4. Changes and Complaints We reserve the right to change our privacy practices and the terms of this notice. If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

Disclaimer: This HIPAA Notice of Privacy Practices is provided as a general informational resource and does not constitute legal advice. This document is not a replacement for a signed medical agreement or personal legal counsel. All patients are required to review and sign official clinic documents prior to receiving therapy or treatment.