Privacy Policy

Notice of Privacy Practices

Effective Date: January 1, 2026

As required by the privacy regulations created as a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA),
this notice describes how health information about you (as a patient of this practice) may be used and disclosed and how you can get access
to your individually identifiable health information. Please review this notice carefully.

Our Legal Duty

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires that all medical and dental records and other individually identifiable health information used or disclosed by the Practice, whether electronically, on paper, or orally, are kept confidential.

“Protected Health Information” (PHI) includes information about you, including demographic information, that may identify you and relates to your past, present, or future physical or mental health condition and related health care services.

We are required by law to:

• Maintain the privacy and security of your PHI
• Provide you with this Notice of Privacy Practices
• Notify you in the event of a breach of unsecured PHI

We reserve the right to change our privacy practices and the terms of this Notice at any time. Updated notices will be posted on our website and made available upon request.

How We May Use and Disclose Your Protected Health Information

Treatment

We may use or disclose your PHI to personnel in our office and to dentists, physicians, and other healthcare professionals involved in your care.

Payment

We may use and disclose your PHI to obtain payment for services we provide. If you pay in full out-of-pocket for a service, you may request that we not disclose that information to your health insurer.

Healthcare Operations

• Quality assessment and improvement activities
• Provider performance evaluations
• Training programs
• Accreditation, certification, licensing, and credentialing

Appointment Reminders

We may contact you via phone, voicemail, text message, postcard, or letter regarding appointments or treatment information.

Business Associates

We may disclose PHI to third-party service providers who perform functions on our behalf. These parties are required to safeguard your information.

Family, Friends, and Personal Representatives

We may disclose PHI to individuals involved in your care unless you object.

Public Health and Legal Requirements

We may disclose PHI when required by law, including for public health activities, abuse or neglect reporting, law enforcement requests, court orders, workers’ compensation claims, national security matters, or to prevent serious threats to health or safety.

Fundraising

We may contact you regarding fundraising efforts. You may opt out of receiving these communications.

Additional Uses Requiring Authorization

Marketing

We will only use or disclose your PHI for marketing purposes with your written authorization.

Sale of Information

We will not sell your PHI without your written authorization.

Psychotherapy Notes

Psychotherapy notes will not be released without your written authorization unless required by law.

Genetic Information

In compliance with the Genetic Information Nondiscrimination Act (GINA), we will not use or disclose genetic information for underwriting purposes.

Your Rights

Right to Access

You have the right to inspect and receive copies of your PHI, including electronic copies where available.

Right to Breach Notification

You will be notified if a breach of your unsecured PHI occurs.

Right to an Accounting of Disclosures

You may request a list of certain disclosures made during the previous six (6) years.

Right to Request Restrictions

You may request restrictions on certain uses and disclosures of your PHI.

Right to Confidential Communications

You may request that we communicate with you by alternative means or at alternative locations.

Right to Amend

You may request that we amend your PHI if you believe it is incorrect or incomplete.

Substance Use Disorder Records (42 CFR Part 2)

Records related to substance use disorder treatment are protected by federal law and require separate written consent for disclosure, except in limited circumstances such as medical emergencies or mandatory child abuse reporting.

Use of Artificial Intelligence (AI)

We may use secure, HIPAA-compliant Artificial Intelligence technologies to assist with clinical decision support, documentation, scheduling, security monitoring, and patient education.

Your PHI will not be used for:

• External product development
• Training third-party AI models
• Marketing or sales purposes

Questions and Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with:

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 877-696-6775

www.hhs.gov/ocr/privacy/hipaa/complaints/

We will not retaliate against you for filing a complaint.

Contact Information

Privacy Officer: Lauren Jones
2 Metroplex Drive, Suite 115
Birmingham, AL 35209
Phone: 205-880-6241
Email: privacy@high5health.com