HIPAA Notice of Privacy Practices

Right to Get an Electronic or Paper Copy of Your Medical Record

You may ask to see or receive an electronic or paper copy of your medical record and other health information we maintain about you.

We will provide a copy or summary of your health information, usually within the time required by law.

We may charge a reasonable, cost-based fee for copies, mailing, supplies, or other permitted costs.

Right to Ask Us to Correct Your Medical Record

You may ask us to correct health information about you that you believe is incorrect or incomplete.

We may deny your request, but we will explain the reason in writing within the time required by law.

Right to Request Confidential Communications

You may ask us to contact you in a specific way, such as by phone, email, text message, patient portal, Spruce, mail, or another method, or to send mail to a different address.

We will say yes to reasonable requests when required by law.

Right to Ask Us to Limit What We Use or Share

You may ask us not to use or share certain health information for treatment, payment, or healthcare operations.

We are not required to agree to every request. If we do agree, we will follow the agreement unless the information is needed to provide emergency treatment or unless otherwise permitted or required by law.

If you pay for a service or healthcare item out of pocket in full, you may ask us not to share that information with your health plan for payment or healthcare operations. We will agree unless a law requires us to share that information.

Right to Get a List of Those With Whom We Have Shared Information

You may ask for an accounting of certain disclosures of your protected health information.

We will include disclosures required by law, but we may not include disclosures for treatment, payment, healthcare operations, disclosures you authorized, and certain other disclosures excluded by law.

We will provide one accounting per year for free. We may charge a reasonable, cost-based fee for additional requests within the same 12-month period.

Right to Get a Copy of This Notice

You may ask for a paper copy of this Notice at any time, even if you agreed to receive the Notice electronically.

We may also make this Notice available through our website, enrollment platform, patient portal, Spruce, Elation/Passport, or another clinic-approved method.

Right to Choose Someone to Act for You

If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights and make choices about your health information.

We may require documentation or other verification before acting on a request from a personal representative.

Right to File a Complaint

You may file a complaint if you believe your privacy rights have been violated.

You may file a complaint with The Doc's Office by contacting us using the contact information listed at the end of this Notice.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.

We will not retaliate against you for filing a complaint.

Family, Friends, and Others Involved in Your Care

You may tell us whether we may share information with your family, close friends, caregivers, or others involved in your care or payment for your care.

If you are unable to tell us your preference, such as during an emergency or if you are incapacitated, we may share information if we believe it is in your best interest.

Disaster Relief Situations

We may share information with disaster relief organizations so your family or others involved in your care can be notified about your condition, location, or general status.

Marketing

We will not use or disclose your protected health information for marketing purposes without your written authorization when authorization is required by law.

Sale of Health Information

We will not sell your protected health information without your written authorization.

Fundraising

The Doc's Office does not currently use protected health information for fundraising. If that changes, you would have the right to opt out of fundraising communications.

Treatment

We may use and share your protected health information to provide, coordinate, or manage your healthcare.

For example, we may share information with another healthcare professional, specialist, laboratory, imaging center, pharmacy, hospital, emergency department, or other provider involved in your care.

Payment

We may use and share your protected health information to bill and collect payment for services, membership-related charges, labs, procedures, specialty programs, or other authorized charges.

Because The Doc's Office is a direct primary care practice, we do not bill insurance for DPC membership fees. However, we may still use or disclose information as needed for payment, payment processing, billing questions, patient statements, payment disputes, collections, or other lawful payment-related purposes.

Healthcare Operations

We may use and share your protected health information to operate the Clinic, improve care, train staff, conduct quality review, manage business operations, contact you when necessary, and comply with legal and professional obligations.

For example, we may use health information to review the quality of care, improve clinic workflow, credential providers, train staff, manage records, conduct audits, or communicate with business associates who support clinic operations.

Required by Law

We may use or disclose your protected health information when required to do so by federal, state, or local law.

Public Health and Safety

We may share your protected health information for public health activities, such as:

• Preventing or controlling disease
• Reporting certain diseases, injuries, or conditions
• Reporting adverse events or product concerns
• Reporting births or deaths when applicable
• Reporting suspected abuse, neglect, or domestic violence when required or permitted by law
• Preventing or reducing a serious threat to health or safety

Health Oversight Activities

We may share your protected health information with health oversight agencies for activities authorized by law, such as audits, investigations, inspections, licensure, disciplinary actions, or compliance reviews.

Legal Proceedings

We may disclose your protected health information in response to a court or administrative order, subpoena, discovery request, or other lawful process, subject to applicable legal requirements.

Law Enforcement

We may share protected health information for law enforcement purposes when permitted or required by law.

Coroners, Medical Examiners, and Funeral Directors

We may share protected health information with coroners, medical examiners, or funeral directors when necessary for them to perform their duties.

Organ and Tissue Donation

We may share protected health information with organizations involved in organ, eye, or tissue donation or transplantation when applicable.

Workers' Compensation

We may share protected health information for workers' compensation claims or similar programs as permitted or required by law.

Specialized Government Functions

We may disclose protected health information for certain specialized government functions, such as military, national security, protective services, correctional institutions, or lawful custody situations, when permitted or required by law.

Research

We may use or disclose protected health information for research purposes only when allowed by law and when applicable privacy protections are followed.