ProSlimDoc Hormone Clinic – Notice of Privacy Practices
Effective Date: May 25 2025
This notice describes how medical information about you may be used and disclosed, and how you can access this information. Please review it carefully.
Jurisdictions Served
- Georgia
- Arizona
Pharmacy Used
Address
12855 Capricorn St, Stafford, TX 77477, United States
Phone number
Our Responsibilities Regarding Your Health Information
Our Responsibilities
At ProSlimDoc, we are committed to safeguarding your protected health information (PHI). In accordance with federal law, we:
Are required by law to maintain the privacy and security of your protected health information.
Will notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
Must adhere to the duties and privacy practices outlined in this Notice and will provide you with a copy.
Will not use or disclose your information beyond what is described in this Notice unless you provide written authorization.
If you authorize us to use or share your information, you may revoke that permission at any time by notifying us in writing.
For more information about your rights and our responsibilities, please visit the U.S. Department of Health and Human Services at:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
How We May Use and Share Your Information
We typically use or share your health information in the following ways:
1. For Your Treatment
We may use and share your PHI with other health professionals involved in your care to provide, coordinate, or manage your treatment and services.
2. For Payment
We may use and disclose your PHI to bill and receive payment from health plans or other entities for the services we provide to you.
3. For Healthcare Operations
We may use and share your PHI to run our practice, improve your care, and contact you when necessary.
4. Other Permitted Uses and Disclosures
We may use or disclose your PHI for:
Public health and safety issues
Legal and law enforcement requirements
Health oversight activities
Responding to lawsuits and legal actions
Research (with your authorization)
Workers’ compensation claims
We will never share your PHI for marketing purposes, sell your PHI, or use your information for fundraising without your written permission.
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways:
Treat you
We can use your health information and share it with other professionals who are 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.
Example: We use health information about you to manage your treatment and services.
Bill for your services
We can use and share your health information to bill and receive payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.
How else can we use or share your health information?
We are allowed or required to share your information in other ways—usually in ways that contribute to the public good, such as public health and research. We must meet many legal conditions before we can share your information for these purposes.
For more information, visit:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html
Help with public health and safety issues
We can share health information about you for certain situations such as:
Preventing disease
Helping with product recalls
Reporting adverse reactions to medications
Reporting suspected abuse, neglect, or domestic violence
Preventing or reducing a serious threat to anyone’s health or safety
Do research
We can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services to confirm our compliance with federal privacy laws.
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
For workers’ compensation claims
For law enforcement purposes or with a law enforcement official
With health oversight agencies for activities authorized by law
For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Your Rights
When it comes to your health information, you have certain rights. This section outlines your rights and our responsibilities to support those rights.
Get an electronic or paper copy of your medical record
You have the right to view or request an electronic or paper copy of your medical record and other health information we maintain about you. Ask us how to submit your request.
We will provide your records or a summary within 30 days of receiving your request. A reasonable, cost-based fee may apply.
Ask us to correct your medical record
If you believe that your health information is incorrect or incomplete, you may request a correction. Ask us how to do this.
We may deny your request, but we will provide a written explanation within 60 days.
Request confidential communications
You can ask us to contact you in a specific way (e.g., at your home, cell, or office phone) or to send mail to a different address.
We will accommodate all reasonable requests.
Ask us to limit what we use or share
You may request that we not use or share certain health information for treatment, payment, or healthcare operations.
While we are not required to agree to all requests, we will consider them carefully.
If you fully pay out-of-pocket for a healthcare item or service, you may request that we not share that information with your health insurer. We will honor this request unless a law requires us to share the information.
Get a list of those with whom we’ve shared information
You have the right to request a list (also known as an “accounting”) of the times we’ve shared your health information over the past six years, who we shared it with, and why.
This list will not include disclosures made for treatment, payment, healthcare operations, or those you authorized.
You are entitled to one free accounting each year. Additional requests may incur a reasonable, cost-based fee.
Get a copy of this privacy notice
You can request a paper copy of this notice at any time, even if you received it electronically. We will promptly provide it upon request.
Choose someone to act for you
If you have given someone medical power of attorney or if someone is your legal guardian, that person can make decisions about your health information.
Before we take action, we will verify that the person has legal authority to act on your behalf.
File a complaint if you feel your rights are violated
If you believe we have violated your privacy rights, you may file a complaint by contacting us directly at the information provided on our website.
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights:
Mail: 200 Independence Avenue, S.W., Washington, D.C. 20201
Phone: 1-877-696-6775
We will not retaliate against you for filing a complaint.
Our Commitment to Data Security
We maintain administrative, technical, and physical safeguards to protect your PHI from unauthorized access, disclosure, alteration, and destruction. Your data is encrypted and stored securely in accordance with HIPAA standards.
Your Choices
For certain health information, you have the right to make choices about what we share. If you have a clear preference for how we share your information in the situations described below, please let us know. We will honor your instructions to the extent allowed by law.
In these cases, you have both the right and choice to tell us to:
Share information with your family members, close friends, or others involved in your care
Share information in a disaster relief situation
Include your information in a hospital directory (if applicable)
If you are unable to communicate your preferences—such as in an emergency or if you are unconscious—we may still share your information if we believe it is in your best interest. We may also share your information when necessary to help prevent a serious and imminent threat to your health or safety or the health or safety of others.
In these cases, we never share your information unless you give us written permission:
For marketing purposes
For the sale of your health information
For most sharing of psychotherapy notes
In the case of fundraising:
We may contact you to support our fundraising efforts, but you always have the right to opt out of future contacts.
Contact Information
If you have any questions about this notice or want to file a complaint, please contact:
Privacy Officer
ProSlimDoc Hormone Clinic
📧 Email: sriabinaya@proslimdoc.com
📞 Phone: (678) 310-6246
📍 Mailing Address: proslimdoc@gmail.com
You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.
Changes to This Notice
We reserve the right to change this notice at any time, and any new notice will be effective for PHI we already have and any we receive in the future. We will post the current notice on our website at https://proslimdoc.com and make it available upon request.