HIPAA

Hipaa Notice Of Privacy Practices

We are required by law to maintain the privacy of, and provide individuals with, this notice of our legal duties and privacy practices with respect to protected health information. We are also required to abide by the terms of the notice currently in effect. If you hany questions regarding this notice, please contact Deja Vu Med Spa by mail or phone. Our contact information is listed above.

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.

This Notice of Privacy Practices is NOT an authorization. This Notice of Privacy Practices describes how we, our Business Associatesand their subcontractors, may use and disclose your protected health information (PHI) to carry out treatment, payment or health coperations and for other purposes that are permitted or required by law. It also describes your rights to access and conprotected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health condition and related health care services.

Uses And Disclosures Of Protected Health Information

Your protected health information may be used and disclosed by your physician, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of the physician’s practice, and any other use required by law.

Treatment

We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, your protecinformation may be provided to a physician to whom you have been referred to ensure that the physician has the neceinformation to diagnose or treat you. We will abide by the patient’s request not to disclose PHI to a health plan for services which thpatient has paid out of pocket and requests the restriction.

Payment

Your protected health information will be used, as needed if applicable, to obtain payment for your health care services.

Healthcare Operations

We may use or disclose, as needed your protected health information to support the business activities of your physician’s practiceThese activities include, but are not limited to, quality assessment, employee review, training of medical students, licensiconducting or arranging for other business activities. For example, we may disclose your protected health information to school students that see patients at our office. I n addition, we may use a sign-i n sheet at the registration desk where you will beasked to sign your name. We may also call you by name in the waiting room when your provider is ready to see you.

We mdisclose your protected health information, as necessary, to contact you to remind you of your appointment, and inform treatment alternatives or other health-related benefits and services that may be of interest to you. We may use or discloprotected health information in the following situations without your authorization. These situations include: as required bypublic health issues as required by law, communicable diseases, health oversight, immunizations to schools, abuse or neglect, foodrug administration requirements, legal proceedings, law enforcement, coroners, funeral directors, organ donation, research, crimactivity, military activity and national security, workers’ compensation, inmates, and other required uses and disclosures. Undelaw, we must make disclosures to you upon your request. Under the law, we must also disclose your protected health information when required by the Secretary of the Department of Healtand Human Services to investigate or determine our compliance with the requirements under Section 164.500. 2

Uses And Disclosures That Require Your Authorization

Other Permitted and Required Uses and Disclosures will be made only with your consent, authorization or opportunity to object unless required by law. The same authorization/restrictions that were used while you are alive will remain in place for up to 50 yearafter your death. Without your authorization, we are expressly prohibited to use or disclose your protected health informamarketing purposes. We may not sell your protected health information without your authorization. We may not use or disclose mopsychotherapy notes contained in your protected health information. We will not use or disclose any of your protected health information that contains genetic information that will be used for underwriting purposes. You may revoke the authorization, at any time, in writing, except to the extent that your physician or the physician’s practice has taken an action in reliance on the use or disclosure indicated in the authorization.

Your Rights

The following are statements of your rights with respect to your protected health information: You have the right to inspect and have a copy of your protected health information (fees may apply). Pursuant to your written request you have the right to inspect or have a copy your protected health information whether in paper or electronic format. The records will be provided within 30 days of request . Under federal law, however, you may not inspect or copy the following records: Psychotherapy notes, information compiled in reasonable anticipation of, orused in, a civil, criminal, or administrative action or proceeding, protected health information restricted by law, information that is related to medical research in which you have agreed to participate, information whose disclosure may result in harm or injury to you or to another person, or information that was obtained under a promise of confidentiality.

Patient Requesting Medical Record Copies. There may be fees associated with requesting copies of medical records, such as copy fees, and/or shipping and handling fees. You have the right to request a restriction of your protected health information – You may ask us not touse or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any your protected health information not be disclosed to family members or friends who may be involved in your care or for notificationpurposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom ywant the restriction to apply.

You have the right to request to receive confidential communications – You may ask us to contact you in a specific way (fexample, home or office phone) or to send mail to a different address. You have the right to request an amendment to your protected health information – You may ask us to correct health information about you that you think is incorrect or incomplete. We may say “no” to your request, but we will tell you why in writing within 60 days. You have the right to receive an accounting of certain disclosures — You have the right to receive an accounting of disclosures, paper or electronic, except for disclosures: pursuant to an authorization, for purposes of treatment, payment, healthcare operatiorequired by law for up to six years prior to the date of the request. You have the right to receive notice of a breach - We will notify you if your unsecured protected health information has been breachedYou have the right to obtain a paper copy of this notice from us even if you have agreed to receive the notice electronically. We reserve the right to change the terms of this notice and we will notify you of such changes on the following appointment. We will alsmake available copies of our new notice if you wish to obtain one.