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Patient Privacy

Notice of Privacy Practices

Effective May 26, 2026. This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

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.

Effective date: May 26, 2026

Our pledge to you

Elevate Wellness & Health (“we,” “us,” or “our practice”) is committed to protecting the privacy of your Protected Health Information (PHI). Federal law — the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its regulations — requires us to maintain the privacy of your PHI, provide you with this notice of our legal duties and privacy practices, and follow the terms of the notice currently in effect.

What is Protected Health Information?

Protected Health Information (PHI) is information about you, including demographic data, that may identify you and that relates to your past, present, or future physical or mental health, the care you receive, or payment for that care.

How we may use and disclose your PHI without your written authorization

We may use and disclose your PHI for the following purposes without your specific authorization:

For treatment

We may use your PHI to provide, coordinate, or manage your medical care. For example, we may share information with another physician, specialist, hospital, or therapist involved in your care.

For payment

We may use and disclose your PHI to obtain payment for the services we provide. For example, we may submit claims to your health insurance carrier or share information with a billing service.

For healthcare operations

We may use and disclose your PHI to operate our practice — for quality improvement, staff training, accreditation, licensing, and business management activities.

Appointment reminders and follow-up

We may contact you to remind you of an appointment, follow up after a visit, or share health-related information about services that may interest you.

Other permitted uses

  • Required by law: when disclosure is required by federal, state, or local law
  • Public health activities: reporting communicable diseases, FDA product safety concerns, etc.
  • Health oversight: audits, investigations, inspections, and licensure activities by health oversight agencies
  • Judicial and administrative proceedings: in response to a court order, subpoena, or other lawful process
  • Law enforcement: as required by law or in response to a valid law enforcement request
  • To avert a serious threat to health or safety: consistent with applicable law and ethical standards
  • Workers' compensation: as authorized by and to the extent necessary to comply with workers' compensation laws
  • Coroners, medical examiners, and funeral directors: as permitted by law
  • Organ and tissue donation: when applicable
  • Research: subject to an approved Institutional Review Board waiver or other safeguards
  • Specialized government functions: military, national security, protective services

Uses and disclosures that require your written authorization

We will obtain your written authorization before using or disclosing your PHI for any purpose not described above. In particular, we will obtain your authorization for:

  • Most uses and disclosures of psychotherapy notes
  • Uses and disclosures of PHI for marketing
  • Disclosures that constitute a sale of PHI

You may revoke any authorization in writing at any time, except to the extent we have already relied on it.

Your rights regarding your PHI

Right to inspect and copy

You have the right to inspect and obtain a copy of the PHI we maintain about you, with limited exceptions. To request access, please contact our Privacy Officer using the information below. We may charge a reasonable fee for copies as permitted by law.

Right to request amendment

If you believe PHI we have about you is incorrect or incomplete, you may ask us to amend it. Requests must be in writing and include a reason supporting the request. We may deny a request that does not meet certain criteria.

Right to an accounting of disclosures

You have the right to request an accounting of certain disclosures we have made of your PHI in the six years prior to your request. This excludes disclosures for treatment, payment, healthcare operations, and disclosures you authorized.

Right to request restrictions

You have the right to request a restriction on certain uses and disclosures of your PHI. We are not required to agree to your request except in limited circumstances — for example, when you have paid for a service in full out of pocket and request that we not share that PHI with your health plan.

Right to request confidential communications

You have the right to request that we communicate with you about medical matters in a specific way or at a specific location (for example, by mail to a P.O. box rather than your home).

Right to a paper copy of this notice

You may request a paper copy of this notice at any time, even if you have agreed to receive it electronically.

Right to be notified of a breach

You have the right to be notified if there is a breach of your unsecured PHI.

Our duties

  • We are required by law to maintain the privacy of your PHI
  • We are required to provide you with this notice
  • We are required to abide by the terms of the notice currently in effect
  • We reserve the right to change this notice and to make the revised notice effective for PHI we already have as well as any PHI we receive in the future. We will post a copy of the current notice on our website and at our office.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer (contact below) or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with HHS, visit hhs.gov/hipaa/filing-a-complaint. We will not retaliate against you for filing a complaint.

Privacy Officer

To exercise any of the rights described above, ask questions about this notice, or file a complaint, please contact our Privacy Officer:

Related policies

See also our Privacy Policy for how we handle non-clinical information collected through the website, and our Terms of Service.

This notice is provided as a starting template based on HIPAA's required elements (45 CFR § 164.520). It should be reviewed and customized by qualified healthcare counsel before being published as your practice's official Notice of Privacy Practices.

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