HIPAA Notice of Privacy Practices

1. Covered Entity Information

This Notice of Privacy Practices is issued by:

Florida Aesthetics & Wellness is a HIPAA-covered entity and is required by the Health Insurance Portability and Accountability Act (HIPAA) to maintain the privacy and security of your Protected Health Information (PHI).

2. Types of Protected Health Information We Collect

We collect and maintain the following types of Protected Health Information (PHI) about you:

• Demographic information (name, address, phone number, email, date of birth)
• Medical history and health conditions
• Medications and allergies
• Prior medical treatments and procedures
• Physical examination findings and clinical observations
• Treatment recommendations and clinical notes
• Results of medical aesthetic treatments and procedures
• Before-and-after photographs
• Payment and billing information
• Insurance information (if applicable)
• Emergency contact information

3. Uses and Disclosures Without Your Authorization

We may use and disclose your Protected Health Information without your written authorization for the following purposes:

For Treatment

We use your PHI to provide you with medical aesthetic services, treatments, and related care. This includes consultation, procedural planning, performing treatments, and follow-up care. We may share your information with other healthcare providers or specialists involved in your care.

For Payment

We use your PHI to bill for services provided, process insurance claims (if applicable), collect payment, and manage your account. This includes sharing information with billing services, payment processors, and your insurance company.

For Healthcare Operations

We use your PHI to operate our business, including appointment scheduling, medical records management, quality improvement, staff training, compliance, and business management. This may include sharing information with our staff, management, and authorized third-party service providers.

For Public Health Activities

We may use or disclose your PHI when required by public health authorities for activities such as disease surveillance, investigation, or control.

For Legal Compliance

We may use or disclose your PHI when required by law, including court orders, subpoenas, or other legal processes.

For Law Enforcement

We may disclose your PHI to law enforcement authorities when required by law or when necessary to comply with legal obligations.

For Health and Safety

We may disclose your PHI when necessary to prevent serious harm to you or others.

4. Uses and Disclosures Requiring Your Authorization

The following uses and disclosures of your Protected Health Information require your written authorization:

• Marketing: Any use of your PHI for marketing purposes beyond treatment reminders and appointment notifications
• Research: Use of your PHI for medical research purposes
• Sale of PHI: Any sale or transfer of your PHI for monetary gain
• Psychotherapy Notes: Use of detailed mental health or psychotherapy notes (if applicable)
• Other Disclosures: Any use or disclosure not described in this Notice

You may revoke your authorization at any time by providing written notice to our Privacy Officer. The revocation will not apply to disclosures already made before we received your notice.

5. Your Privacy Rights

You have the following rights regarding your Protected Health Information:

Right to Access

You have the right to access, inspect, and copy your medical records and billing records. You may request records in paper or electronic form. We will provide you with access within 30 days of your request. We may charge a reasonable fee for copies and administrative costs.

Right to Amendment

You have the right to request amendment or correction of your medical records if you believe the information is inaccurate or incomplete. We will review your request and may accept or deny it. If denied, you have the right to file a statement of disagreement with our determination.

Right to an Accounting of Disclosures

You have the right to request an accounting of disclosures of your Protected Health Information. This accounting will show who we have shared your information with and for what purposes. We will provide this information within 60 days of your request. One accounting per year is free; additional requests may involve a reasonable fee.

Right to Request Restrictions

You have the right to request restrictions on how we use and disclose your Protected Health Information. However, we are not required to agree to all restrictions. Any agreed-upon restrictions will be documented in writing and honored by our practice.

Right to Request Confidential Communications

You have the right to request that we communicate with you about your health information in a confidential manner. For example, you may request that we contact you only by cell phone or email. We will accommodate reasonable requests.

Right to Receive Notice

You have the right to receive this Notice in paper form. You may also request an electronic copy.

Right to File a Complaint

You have the right to file a complaint with Florida Aesthetics & Wellness or with the U.S. Department of Health and Human Services Office for Civil Rights if you believe we have violated your privacy rights. Filing a complaint will not affect your treatment or services.

6. How to Exercise Your Privacy Rights

To exercise any of these rights, please contact our Privacy Officer in writing:

We will respond to your request within the timeframe required by law. If you need assistance or have questions, our staff will help guide you through the process.

7. How to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with Florida Aesthetics & Wellness or with the U.S. Department of Health and Human Services Office for Civil Rights.

File a Complaint with Florida Aesthetics & Wellness:

File a Complaint with HHS Office for Civil Rights:

U.S. Department of Health and Human Services
Office for Civil Rights
Region IV (Florida)
Atlanta Federal Center, 61 Forsyth Street, SW
Suite 16T26, Atlanta, GA 30303
Phone: (404) 562-7886
Toll-Free: 1-800-537-7697
Web: https://www.hhs.gov/ocr

You will not be retaliated against for filing a complaint.

8. Security of Your Protected Health Information

Florida Aesthetics & Wellness is committed to protecting the security and confidentiality of your Protected Health Information. We implement administrative, physical, and technical safeguards to prevent unauthorized access, use, or disclosure of your information. These safeguards include:

• Secure storage of medical records in locked, restricted-access areas
• Encryption of electronic data and communications
• Secure login credentials and access controls
• Regular security training for staff members
• Background checks for employees with access to PHI
• Policies and procedures for proper handling and disposal of records
• Incident response procedures for potential breaches

9. Changes to This Notice

Florida Aesthetics & Wellness reserves the right to amend this Notice of Privacy Practices at any time. Changes will be effective for all Protected Health Information we maintain. We will provide you with a revised Notice upon request and will post the updated Notice on our website.

10. Acknowledgment of Receipt

We require that all patients acknowledge receipt of this Notice of Privacy Practices. You may be asked to sign a receipt or provide electronic acknowledgment. Refusal to acknowledge receipt will not affect your ability to receive treatment.

11. Patient Responsibilities

To help us protect your privacy, we ask that you:

• Keep your contact information current
• Inform us of any changes to your emergency contact information
• Notify us if you believe your privacy has been violated
• Follow our policies regarding access to your records
• Maintain the confidentiality of your account credentials

12. Effective Date and Questions

This Notice of Privacy Practices is effective as of January 1, 2026. If you have any questions about this Notice or your privacy rights, please contact our Privacy Officer at the information listed above. We are committed to answering your questions and addressing your concerns promptly.

Florida Aesthetics & Wellness takes your privacy seriously and is committed to complying with all applicable HIPAA regulations. This Notice is in accordance with the HIPAA Privacy Rule and other applicable state and federal laws.