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Notice of Privacy Practices

Effective Date: August 21, 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.

 

Your Rights

You have the right to:

  • Obtain a copy of your medical record in paper or electronic form.

  • Request corrections to your medical record if you believe it is incomplete or incorrect.

  • Request confidential communications.

  • Ask us to restrict certain uses or disclosures of your information.

  • Receive an accounting of disclosures we have made of your information.

  • Receive a paper copy of this Notice upon request.

  • Choose a personal representative to act on your behalf.

  • File a complaint if you believe your privacy rights have been violated.

 

Your Choices

You may decide how we use and share certain information. For example, you can tell us your preferences about:

  • Sharing information with family, friends, or others involved in your care.

  • Sharing information for disaster relief.

  • Using information for marketing communications.

  • Using your information for fundraising activities.

 

Our Uses and Disclosures

We typically use or share your health information to:

  • Treat you – We can share information with other professionals involved in your care.

  • Run our practice – We can use and share your information to improve your care and manage daily operations.

  • Bill for services – We can use and share your information to bill and receive payment from health plans or other payors.

We may also use or share your information when required by law or for the public good, such as:

  • Preventing or reporting public health and safety issues.

  • Conducting health research.

  • Complying with applicable laws and regulations.

  • Responding to legal actions, subpoenas, or court orders.

  • Working with medical examiners, funeral directors, or organ donation programs.

  • Addressing workers’ compensation, law enforcement, or government requests.

 

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information (PHI).

  • We will notify you promptly if a breach occurs that may have compromised your information.

  • We must follow the duties and privacy practices described in this Notice.

  • We will not use or share your information other than as described in this Notice unless you authorize us in writing. You may revoke your authorization at any time.

 

Changes to This Notice

We reserve the right to change this Notice at any time. The updated Notice will be posted on our website and will be available in our office.

 

Contact Information

Privacy Officer: Dominique Olivier-Hines, CRNP, FNP-C
Practice Name: DH Health and Wellness
Address: 1055 Taylor Ave, Suite 216, Towson, MD 21286
Email: info@mydhhealth.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:

We will not retaliate against you for filing a complaint.

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