Notice of Privacy Practices (HIPAA) Effective Date: January 1, 2025 Organization: SlimNow Medical Weight Loss Privacy Official Contact: Cassie Fisher (Privacy Official) SlimNow Medical Weight Loss 5607 Franklin Rd, Murfreesboro, TN 37128 Phone: (615) 439-6929 Email: info@slimnowtn.com How We Treat Protected Health Information (PHI) We are committed to protecting the privacy of your medical information. We create and maintain records of the care and services you receive to provide quality treatment and meet legal requirements. We may use or disclose your PHI to: Treat you (e.g., share information with providers involved in your care). Bill and receive payment (e.g., submit claims to your insurance). Run our healthcare operations (e.g., quality improvement, training, audits, compliance). Meet legal/public health obligations (e.g., report certain diseases, respond to court orders, prevent serious threats to health or safety, health oversight activities). Other uses or disclosures not described in this Notice will be made only with your written authorization, which you may revoke in writing at any time, except to the extent action has already been taken in reliance on it. Your Rights Regarding Your PHI You have the right to: Access inspect and get a copy of your medical record (paper or electronic). Request an amendment if you believe information is incorrect or incomplete. Request confidential communications (e.g., contact you at a different address/number). Request restrictions on certain uses/disclosures (we will consider but may not be required to agree, except we must agree to restrict disclosures to a health plan for services you paid for in full out-of-pocket). Receive an accounting of disclosures (a list of certain disclosures made in the past six years). Get a paper copy of this Notice at any time. Choose a personal representative to act for you if applicable. How to exercise your rights: Send a written request to the Privacy Official listed above. We will respond within the timeframes required by law. Our Legal Duties We are required by law to maintain the privacy of your protected health information, provide you with this Notice, and notify you following a breach of unsecured PHI. We must follow the terms of this Notice currently in effect. We may change our privacy practices and this Notice. If we do, the revised Notice will carry a new effective date and be posted in our clinic and on our website. You may obtain a copy at any visit or by contacting the Privacy Official. Questions or Complaints If you have questions about this Notice or believe your privacy rights have been violated, contact: Cassie Fisher, Privacy Official SlimNow Medical Weight Loss Phone: (615) 439-6929 • Email: info@slimnowtn.com Address: 5607 Franklin Rd, Murfreesboro, TN 37128 You may also complain to the U.S. Department of Health & Human Services, Office for Civil Rights. We will not retaliate for filing a complaint.
