Notice of Privacy Practices

We use and disclose your PHI to provide, coordinate, and manage your health care — for example, to evaluate your intake, write a prescription, transmit your prescription to a compounding pharmacy, and follow up on your treatment.

We use and disclose PHI to obtain payment for services and medication — for example, to process your subscription payment or to verify your identity for fraud prevention.

We use and disclose PHI for activities that support our practice, including quality assessment, provider credentialing, training, compliance, audits, and customer support.

We may use or disclose PHI as required or permitted by law, including for public-health activities, reporting suspected abuse or neglect, health-oversight activities, judicial and administrative proceedings, law-enforcement purposes, organ donation, research with appropriate authorization or waiver, workers' compensation, military and veteran activities, national security, correctional institutions, and to avert a serious threat to health or safety.

Other uses and disclosures of PHI — including most uses and disclosures of psychotherapy notes (if any), uses and disclosures for marketing, and sales of PHI — will be made only with your written authorization. You may revoke any authorization at any time in writing, except to the extent we have already acted in reliance on it.

You have the right to inspect and obtain a copy of your PHI in our records, in the form and format you request if readily producible, including an electronic copy. We may charge a reasonable, cost-based fee.

You have the right to request that we amend PHI that you believe is incorrect or incomplete. We may deny your request in certain circumstances and will provide a written explanation.

You have the right to receive a list of certain disclosures we have made of your PHI in the six years before your request (excluding disclosures for treatment, payment, health-care operations, and certain other categories).

You have the right to request restrictions on certain uses and disclosures of your PHI. We are not required to agree, except that we must agree to restrict disclosures to a health plan for items you paid for out of pocket in full.

You have the right to request that we communicate with you about medical matters in a specific way or at a specific location (for example, by mail at a particular address). We will accommodate reasonable requests.

You have the right to a paper copy of this Notice at any time on request, even if you have agreed to receive it electronically.

You have the right to be notified following a breach of unsecured PHI as required by federal regulation.

To exercise any of these rights, email privacy@goodmeds.org or write to [Affiliated Medical Group — pending clinical partner agreement], c/o Opero Labs, Inc., Attn: Privacy Officer, 1616 E 56th Street, Unit 1508, Chicago, IL 60637. We may require you to submit a written request and verify your identity.