Notice of Privacy Practices

1. Who We Are

RASMED Clinic ("we," "our," or "the Clinic") operates medical practices at:

• Valley Stream: 139 N Central Avenue, Valley Stream, NY 11580
• Brooklyn: 1199 Ocean Ave, Brooklyn, NY 11230

We are required by law to maintain the privacy of your protected health information (PHI), to provide you with this Notice of our legal duties and privacy practices with respect to PHI, and to notify you following a breach of unsecured PHI.

2. How We May Use and Disclose Your Health Information

The following categories describe the ways we may use and disclose PHI without your written authorization. Not every use or disclosure in a category will be listed, but all of the ways we are permitted to use and disclose information will fall within one of the categories.

Treatment

We may use your PHI to provide, coordinate, or manage your healthcare and related services. For example, we may disclose your PHI to physicians, nurses, technicians, medical students, or other clinic personnel who are involved in your care.

Payment

We may use and disclose your PHI to obtain payment for services we provide to you. For example, we may contact your health insurer to determine whether it will pay for your healthcare and, if so, how much. We may also share information with other providers for their payment activities.

Healthcare Operations

We may use and disclose your PHI in connection with our healthcare operations, including quality assessment, provider training, licensing activities, conducting or arranging for other business activities, and contacting you via appointment reminders and health communications.

As Required by Law

We will disclose PHI about you when required to do so by federal, state, or local law, including reporting requirements to public health authorities and law enforcement agencies.

Public Health Activities

We may disclose your PHI for public health activities and purposes such as reporting communicable diseases, preventing or controlling disease, or reporting adverse events related to medications or products.

Serious Threats to Health or Safety

We may use and disclose your PHI when necessary to prevent a serious threat to your health or safety or the health or safety of the public or another person.

Workers' Compensation

We may disclose your PHI to the extent authorized by and necessary to comply with workers' compensation laws and other similar legally established programs.

3. Uses and Disclosures Requiring Your Authorization

Other uses and disclosures of your PHI not covered by this Notice or by the laws that apply to us will be made only with your written authorization. This includes, but is not limited to:

• Most uses and disclosures of psychotherapy notes
• Uses and disclosures of PHI for marketing purposes
• Disclosures that constitute a sale of your PHI

If you authorize us to use or disclose your PHI, you may revoke that authorization in writing at any time.

4. Your Rights Regarding Your Health Information

Right to Inspect and Copy

You have the right to inspect and copy your PHI that is maintained in our records used to make decisions about your care. To inspect or copy your PHI, submit a written request to our Privacy Officer. We may charge a reasonable fee for the cost of copying, mailing, or other supplies associated with your request.

Right to Amend

If you feel that the PHI we have about you is incorrect or incomplete, you may ask us to amend it. You have the right to request an amendment for as long as we maintain the information. To request an amendment, submit a written request to our Privacy Officer explaining why the amendment is needed.

Right to an Accounting of Disclosures

You have the right to request an accounting of disclosures. This is a list of the disclosures we have made of your PHI. Certain disclosures are excluded from the accounting (e.g., disclosures for treatment, payment, and healthcare operations).

Right to Request Restrictions

You have the right to request a restriction or limitation on the PHI we use or disclose about you for treatment, payment, or healthcare operations. We are not required to agree to your request except in certain circumstances where you pay for services out of pocket in full.

Right to Request Confidential Communications

You have the right to request that we communicate with you about healthcare matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice at any time. You may ask us to give you a copy of this Notice at any clinic visit, or you may obtain a copy at any time by visiting our website at rasmednyc.com/privacy-notice.

5. Changes to This Notice

We reserve the right to change this Notice and make the new Notice apply to PHI we already have as well as any information we receive in the future. We will post a copy of the current Notice on our website. The Notice will contain the effective date on the first page.

6. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with us, contact our Privacy Officer at the address below. All complaints must be submitted in writing. You will not be penalized or retaliated against for filing a complaint.

7. Contact Our Privacy Officer

For questions about this Notice or to exercise your rights, please contact: