Refund Policy

Medical Provider Privacy Practices

Effective Date: 11/08/23

This notice delineates the manner in which your medical information may be employed and divulged and provides a means for you to access said information. Please scrutinize this document attentively.


We are committed to preserving the confidentiality of your medical data and to promptly informing affected individuals in the event of any breach of unsecured medical information, as necessitated by state and federal laws. This notice elucidates our legal responsibilities and privacy procedures concerning your medical information.


The subsequent categories expound on the diverse methods through which we typically employ and disclose medical information, elucidating the purposes for such usage and disclosure, as well as the grounds justifying these actions. It should be noted that we may employ various means of communication with your approval, such as text messages, emails, secure video, or phone calls. In most cases, your initial contact with the pertinent medical provider will likely transpire via video or phone communication.

To be precise, the relevant medical provider may contact you for the following explicit reasons and via the following distinct methods:

Type & Purpose:

  • Video or Phone Communications: To obtain necessary information for delivering services discuss diagnoses, and treatment.
  • Email Communications: To gather essential information for service provision, discuss diagnoses and treatment, and furnish information on special offers and deals.
  • Text Messages: To obtain requisite information for service provision and engage in discussions regarding diagnoses and treatment.
  • Customer Service Emails, Texts, or App Notifications: To provide updates on order issues, shipment delays, and other matters pertaining to your visits with the provider.
  • Tracking Emails: To inform you about prescription shipments, estimated arrival times, and other confirmatory notices.
  • Order Information: To relay information regarding order contents, such as additional products or samples.
  • Referral Programs: To furnish details about potential benefits associated with referring other patients.
  • For Treatment: We may employ and disclose medical information to provide you with healthcare treatment and related services, including coordinating and managing your healthcare. Medical information may be disclosed to physicians, nurses, and other healthcare providers involved in your care, both within and outside the purview of the pertinent medical provider. For example, if your care necessitates a pharmacy referral for prescription drugs, your medical information may be shared to assist the pharmacist in your treatment.
  • For Payment: We may utilize and disclose medical information to bill and collect payments from you, insurance companies, or third parties for the healthcare services we furnish. This may encompass disclosing medical information to obtain prior authorization for treatment and procedures from your insurance plan. For instance, we may submit a payment claim to your insurance company, which may include codes describing the services provided to you. Nevertheless, if you pay for a service or item in full out of pocket and request that we refrain from disclosing medical information solely pertaining to that item or service to your health plan, as elucidated in Section IV of this Notice, we will adhere to your restriction unless mandated by law.
  • For Health Care Operations: We may employ and disclose medical information for the operation of our healthcare practice and to enhance the quality of care. This may entail utilizing or disclosing your medical information to assess the quality of care, conduct cost management, engage in administrative or quality improvement activities, or provide data to our insurance carriers.
  • Quality Assurance and Utilization Review: We may require the use or disclosure of your medical information for internal processes that assess and facilitate the delivery of quality care to our patients. Additionally, your medical information may be used or disclosed for the evaluation of appropriate service levels based on your condition and diagnosis.
  • Credentialing and Peer Review: We may use or disclose your medical information to review the credentials, qualifications, and actions of our healthcare providers.
  • Treatment Alternatives: We may utilize and disclose medical information to apprise you of or recommend potential treatment options or alternatives that we believe may interest you.
  • Appointment Reminders and Information about Health-Related Benefits and Services: We may employ and disclose medical information to contact you for appointment reminders and to provide other health-related information. Refer also to the specific types of communications mentioned earlier.
  • Vendors: Certain services, such as billing or legal services, may be rendered to or on behalf of medical providers.
  • Individuals Involved in Your Care or Payment for Your Care: Medical information about you may be disclosed to family members, friends, or those aiding in the payment of your care, provided it aligns with state or federal laws or your prior authorization.
  • As Required by Law: We will disclose medical information when compelled to do so by federal, state, or local laws or regulations.
  • Other: Subject to applicable legal prerequisites, and when pertinent to your medical care or mandated by law, we may use your medical information to prevent an imminent health or safety threat, for organ donation, for research, to comply with military authorities (if you are in the armed forces), for workers' compensation programs, public health activities, health oversight activities, legal matters, law enforcement purposes, to coroners and medical examiners, or for marketing or fundraising purposes.
  • Electronic Disclosures of Medical Information: Some states require notice if your medical information is electronically disclosed. This Notice serves as a general notification that your medical information may be electronically disclosed for treatment, payment, healthcare operations, or as authorized or mandated by state or federal law.


  • On certain occasions, we may find it necessary or beneficial to utilize or disclose your medical information for purposes not explicitly outlined above. In such cases, we will require your prior written authorization. With the exception of provisions expressly detailed herein, all other uses or disclosures of your medical information shall necessitate your specific written consent.
  • Psychotherapy Notes, Marketing, and Sale of Medical Information: In most instances, the utilization and disclosure of "psychotherapy notes," the utilization and disclosure of medical information for marketing purposes, and any disclosures constituting a "sale of medical information" as per relevant state and federal statutes, shall mandate your authorization. The healthcare providers do not anticipate any sale of medical information, nor do they foresee the utilization or disclosure of psychotherapy notes created by a Provider during the course of providing mental health therapy, except as required to provide ongoing mental health care.
  • Should you furnish us with written authorization to use or disclose your medical information for the aforementioned purposes, you retain the right to revoke said authorization in writing at any juncture. Upon revocation, we shall cease any further use or disclosure of your medical information covered by your written authorization. It is important to understand that any uses or disclosures made prior to the revocation, which were reliant upon your authorization, cannot be retracted. We are also obligated to maintain records of the care provided to you.


Specific statutes and regulations grant you certain rights concerning your medical information in our possession. The following is a synopsis of these rights:

In most circumstances, you have the entitlement to inspect and/or obtain copies of your medical information within our designated record set. This set typically encompasses your medical and billing records. To initiate the process of inspecting or copying your medical information, you must submit a written request to the relevant medical provider at Should you request a copy, we may impose a fee covering the costs of copying, postage, or any requisite supplies associated with your request. This fee shall adhere to the limits established by state law. If your medical information is stored in electronic format, such as an electronic medical record, electronic billing record, or another group of records employed to make decisions concerning your care, and you request an electronic copy in a specific format, we will supply it in your requested electronic form and format, provided it is readily producible in that form. If not, we shall provide access in an easily readable electronic form and format, as agreed upon between the relevant medical provider and yourself. In exceedingly rare circumstances permitted by law, we may deny your request to review or copy your medical information, providing a written denial. Should your access be denied, you have the right to request a review of the denial. An alternative licensed healthcare professional, chosen by our medical director and distinct from the individual who issued the denial, shall conduct this review. We shall abide by the outcome of the review.

If you believe that the medical information we possess about you is inaccurate or incomplete, you have the prerogative to request an amendment. This right extends for as long as the information is retained by the relevant medical provider. To submit an amendment request, you must furnish a written request to, along with a rationale for seeking the amendment. If we accept your request, we will notify you in writing. We may decline your amendment request if it is not in writing or lacks a supporting rationale. Moreover, we may refuse if you request amendments to information that (i) we did not create (unless you can establish that the entity responsible for creating the information is no longer available to act on the requested amendment), (ii) is not part of the information retained by the pertinent Medical provider, (iii) does not belong to the category of information you are permitted to inspect and copy, or (iv) is accurate and complete. If your request is denied, you will receive a written notification of the denial.

You possess the right to request an "accounting of disclosures" of your medical information. This accounting is a compilation of disclosures made up to six years prior to the date of your request. However, it may not encompass disclosures for Treatment, Payment, or Health Care Operations (as delineated in this Notice), disclosures executed per your specific authorization (as elucidated in this Notice), or certain other disclosures. To make a request for an accounting, you must submit a written request to Your request must specify a time frame not exceeding six years and indicate your preferred format (e.g., paper or electronic). Your initial request within a twelve-month period is free of charge. Subsequent requests may incur a reasonable fee to cover the costs of producing the list. You will be informed of the associated cost, and you may modify or retract your request before incurring any expenses.

You are entitled to request a limitation or restriction on the use or disclosure of your medical information for Treatment, Payment, or Health Care Operations. This right extends to the disclosure of your medical information to individuals involved in your care or responsible for payment, such as family members or friends. Nevertheless, with the exception of situations explicitly detailed in this Notice, we are not compelled to consent to your request for a limitation or restriction. Should we agree, we shall adhere to your stipulated restrictions unless the information is required for emergency treatment or by law. Additionally, there may be instances where we cannot acquiesce to your request, particularly if legal obligations necessitate the use or disclosure of your medical information. To request restrictions, you must submit a written request to, specifying the information you intend to limit, whether you seek restrictions on use, disclosure, or both, and to whom you wish these limits to apply. In most cases, we retain the discretion to deny requests for restrictions on otherwise allowable disclosures. However, if you or another entity (other than a health plan) makes full out-of-pocket payment for an item or service, and you request that we refrain from disclosing medical information solely related to that item or service to a health plan for payment or healthcare operations purposes, we must honor your restriction request unless mandated by law. It is important to note that such restrictions may have unintended repercussions, especially when other providers require access to this information, such as a pharmacy processing a prescription. It is your responsibility to notify such providers of this restriction. Furthermore, this restriction may impact an insurance company's willingness to cover related expenses not subject to the restriction.

Right to Request Confidential Communications: You maintain the right to request confidential communication regarding medical matters through specific channels or at designated locations. For instance, you can request that we communicate exclusively through a personal email address and refrain from contacting you at your workplace, or vice versa. To initiate such confidential communications, submit a written request to We will not inquire about the rationale behind your request and will make reasonable efforts to accommodate reasonable requests. However, certain requests may not be feasible for us to fulfill.

You possess the right to receive a paper copy of this Notice upon request. You may solicit a copy of this Notice at any time by submitting a written request to


We hereby assert our prerogative to modify this Notice at our discretion, in conjunction with our privacy policies and procedures. Such alterations may extend to medical information already in our possession concerning you, as well as any forthcoming information received. We shall publish a current version of this notice, together with an announcement of any implemented changes, as pertinent, on our website and within any physical office wherein medical providers engage in medical practice. Upon the enactment of changes to this Notice, you may procure a revised copy by directing a written request to


 If you harbor the belief that your privacy rights, as expounded in this Notice, have been transgressed, you possess the right to lodge a complaint with the appropriate medical provider