Notice of Privacy Practices
Effective Date: January 1, 20251. Your Health Information
We create and maintain your health records, including intake forms, consultation notes, wellness assessments, treatment plans, progress tracking, and any health information you provide verbally, in writing, or electronically. We are required by law to maintain the confidentiality of your PHI and to provide you with this notice of our legal duties and privacy practices.
2. How We May Use and Disclose Your Health Information
We may use and disclose your PHI for the following purposes:
- Treatment: To provide you with health services, coordinate care with other wellness professionals, and ensure your safety during sessions.
- Payment: To bill and collect payment from you, your insurance provider, or third-party payers for services rendered.
- Healthcare Operations: To improve the quality of our services, conduct staff training, perform internal audits, and manage our wellness programs.
- With Your Authorization: For any use or disclosure not listed here, we will obtain your written consent or authorization first.
- As Required or Permitted by Law: We may disclose your information when required by federal, state, or local law, or to comply with legal processes such as subpoenas or court orders.
- Public Health & Safety: To report diseases, injuries, adverse events, or potential threats to public health and safety as mandated or permitted by law.
- Research & Quality Improvement: De-identified or approved data may be used for wellness research, with appropriate safeguards in place.
3. Your Rights Regarding Your Health Information
You have the following rights to control your health information. To exercise these rights, please contact our Privacy Officer using the information provided at the end of this notice.
- Right to Access & Copy: You may request to see and obtain copies of your health records. We may charge a reasonable, cost-based fee for copies or mailing.
- Right to Request Amendment: If you believe your PHI is incorrect or incomplete, you may request an amendment. We may deny the request under certain circumstances but will notify you of the reason and your right to file a statement of disagreement.
- Right to Request Restrictions: You may ask us to limit how we use or disclose your PHI for treatment, payment, or operations. We are not always required to agree, except when you pay out-of-pocket in full for a service and request we not share it with your insurer.
- Right to Confidential Communications: You may request that we contact you in a specific way or at a particular location (e.g., only via encrypted email or text). We will accommodate reasonable requests.
- Right to an Accounting of Disclosures: You may request a list of certain disclosures we made of your PHI (excluding those for treatment, payment, operations, or with your authorization) within the past six years.
- Right to a Paper Copy: You may request a printed copy of this Notice at any time, even if you have previously agreed to receive it electronically.
4. How to Obtain a Paper Copy of This Notice
If you received this Notice electronically, you may request a paper copy at any time. Simply contact our Privacy Officer, and we will provide a printed version free of charge.
5. How to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with:
- VitaWell Privacy Officer: No retaliation will be taken against you for filing a complaint.
- U.S. Department of Health & Human Services (HHS): Office for Civil Rights, 200 Independence Avenue, S.W., Washington, D.C. 20201, or via https://www.hhs.gov/ocr/privacy/hipaa/complaints/
6. Changes to This Notice
We reserve the right to change this Notice of Privacy Practices at any time. Any revised notice will be effective for all PHI we maintain. We will post the new notice in our facilities and on our website. If a material change affects the information already collected, we may provide updated notices or obtain new acknowledgments as required.
Contact Our Privacy Officer
VitaWell Health & Wellness
Privacy Compliance Department
123 Wellness Boulevard, Suite 200
Austin, TX 78701
📞 (512) 555-0198 | ✉️ privacy@vitawell.com
Available Monday–Friday, 8:00 AM – 6:00 PM CST