HIPAA Notice of Privacy Practices
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may not be able to grant your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
Ask us to limit what we use or share
You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
If you pay out-of-pocket in full for a service, you can ask us not to share that information with your insurer. We will say “yes” unless a law requires us to share it.
Get a list of those with whom we’ve shared information
You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
We will include all the disclosures except for those about treatment, payment, and operations, and certain other disclosures.
We’ll provide one accounting a year for free; additional requests may incur a reasonable, cost-based fee.
Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive it electronically.
Choose someone to act for you
If someone has medical power of attorney or is your legal guardian, that person can exercise your rights and make choices about your health information.
File a complaint if you feel your rights are violated
You can complain by contacting us using the information at the top of the page. You can also file a complaint with the U.S. Department of Health and Human Services at:
200 Independence Avenue, S.W., Washington, D.C. 20201
1-877-696-6775
www.hhs.gov/ocr/privacy/hipaa/complaints/
We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share.
You can tell us to:
- Share information with family, friends, or others involved in your care
- Share information in a disaster relief situation
- Include your information in a hospital directory
If you are unable to express a preference, we may share your information if we believe it is in your best interest or to lessen a serious and imminent threat.
We never share your information for these purposes unless you give us written permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
Our Uses and Disclosures
We typically use or share your health information to:
Treat you
We can use your health information and share it with other professionals treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
Other uses allowed or required by law:
We may share your information for public health and research purposes after meeting legal requirements.
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing serious threats to health or safety
Other situations:
- For health research
- To comply with federal/state law
- With a medical examiner or funeral director
- For workers’ compensation
- For law enforcement or government requests
- In response to lawsuits and legal actions
Our Responsibilities
- We are required to maintain the privacy and security of your health information.
- We will inform you if a breach compromises your information.
- We must follow the duties and privacy practices described here and provide you a copy.
- We won’t use or share your information unless you authorize it in writing.
For more info: HIPAA Consumer Rights
Sharing Your Information
We do not share your phone number or SMS opt-in information with third parties for marketing purposes.
Data Security
We implement reasonable measures to protect your personal information from unauthorized access or disclosure.
Contact Us
If you have questions or concerns about our privacy practices, contact us at 813-932-7939
Changes to the Terms of This Notice
We may change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available in our office and on our website.
Terms and Conditions (Terms of Service)
Effective Date: 6/16/2025
1. SMS Messaging Service
By providing your phone number, you consent to receive SMS messages for appointment reminders, marketing, and two-way communication. Msg frequency varies. Msg & data rates may apply. Reply HELP for support. Reply STOP to opt out.
2. Message Frequency
You will receive several text messages per month, depending on appointments and preferences.
3. Message and Data Rates
Message and data rates may apply based on your mobile carrier’s terms.
4. Privacy Policy
Your information will be handled according to our Privacy Policy (see above).
5. Opt-Out Instructions
You may opt out anytime by replying “STOP” to any SMS. Reply “HELP” for support or call us at 813-932-7939.
6. Liability
We are not responsible for charges, errors, or delays in SMS delivery caused by your carrier or third-party providers. By opting in, you confirm you are the owner or authorized user of the phone number and at least 18 years old.