NOTICE OF PRIVACY PRACTICES

This notice describes how medical information about you may be used and disclosed, and how you can gain access to this information. Please review it carefully. If your medical record includes information related to reproductive health care, we will use and disclose that information in accordance with applicable federal and state law, including any additional protections that may apply. Protected health information (PHI) about you is maintained as a written and/or electronic record of your contacts or visits for healthcare services with our practice. PHI includes information about you, including demographic information (eg, name, address, phone number), that may identify you and relates to your past, present or future physical or mental health condition and related healthcare services. Our practice is required to follow specific rules on maintaining the confidentiality of your PHI, using your information, and disclosing or sharing this information with other healthcare professionals involved in your care and treatment. This Notice describes your rights to access and control your PHI. It also describes how we follow applicable rules and use and disclose your PHI to provide your treatment, obtain payment for services you receive, manage our healthcare operations and for other purposes that are permitted or required by law.

YOUR RIGHTS UNDER THE PRIVACY RULE

You have the right to receive, and we are required to provide you with, a copy of this Notice of Privacy Practices. We are required to follow the terms of this notice. We reserve the right to change the terms of our notice at any time. Upon request, we will provide you with a revised notice. The Notice will also be posted in a conspicuous location within the practice.

You have the right to authorize other uses and disclosures. This means you may authorize any use or disclosure of PHI not described in this notice. For example, we would need your written authorization to use or disclose your PHI for marketing purposes, for most uses or disclosures of psychotherapy notes, or if we intended to sell your PHI. You may revoke an authorization at any time, in writing, except to the extent that action has already been taken in reliance on that authorization.

You have the right to request an alternative means of confidential communication. This means you may ask us to contact you about medical matters using an alternative method (eg, email, phone) or at a different location. We will accommodate reasonable requests.

You have the right to inspect and copy your PHI. This means you may inspect and obtain a copy of your health record. If your health record is maintained electronically, you may request a copy in electronic format. We may charge a reasonable, cost-based fee for copies in accordance with applicable law.

You have the right to request a restriction of your PHI. This means you may ask us not to use or disclose certain information for treatment, payment or healthcare operations. We are not required to agree to most requested restrictions, but if we do, we will comply except in emergency situations. You also have the right to request that we not disclose information to your health plan if you have paid for a service in full out-of-pocket. We are required to honor that request.

You have the right to request an amendment to your PHI for as long as we maintain the information. In certain cases, we may deny your request.

You have the right to request an accounting of disclosures. This means you may request a list of certain disclosures of your PHI made by us.

You have the right to receive notification of a breach. You will be notified if we discover a breach of your unsecured PHI and determine that notification is required under applicable law.

Written requests related to the above rights may be submitted to info@northcoastdermatology.com.

HOW WE MAY USE OR DISCLOSE YOUR PHI

The following are examples of how we may use and disclose your PHI. These examples are not exhaustive.

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services. This includes sharing information with other healthcare providers involved in your care, such as pharmacies or specialists.

Payment

We may use your PHI to obtain payment for healthcare services. This may include activities such as determining eligibility or coverage with your insurance provider.

Healthcare operations

We may use or disclose your PHI to support the business activities of our practice. These activities include quality assessment, staff training, licensing, and conducting or arranging for other business activities.

Appointment reminders and communications

We may use your PHI to contact you regarding appointments, test results, or treatment-related information.

Health Information Organizations

We may participate in health information organizations (HIOs) to facilitate the secure exchange of medical information for treatment, payment or healthcare operations.

Individuals involved in your care

Unless you object, we may disclose relevant information to a family member, friend or other person involved in your care or payment for your care. If you are unable to agree or object, we may use professional judgment to determine whether the disclosure is in your best interest.

Other permitted and required uses and disclosures

We may also use or disclose your PHI as required or permitted by law, including for public health activities, health oversight, legal proceedings, law enforcement, and other purposes as required by applicable regulations.

PRIVACY COMPLAINTS

You have the right to file a complaint if you believe your privacy rights have been violated. You may contact us directly at: info@northcoastdermatology.com. You may also file a complaint with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

OUR LEGAL DUTIES

We are required by law to maintain the privacy of your PHI and provide you with this notice of our legal duties and privacy practices. We are required by law to notify you following a breach of unsecured PHI. We are required to abide by the terms of this notice currently in effect. If you have questions about this notice, please contact us at info@northcoastdermatology.com. Please sign the accompanying acknowledgment form which acknowledges that you have received and had the opportunity to review this notice.

Effective date: September 23, 2013
Revised: April 4, 2026