HIPAA NOTICE OF PRIVACY PRACTICES

(This one is legally important — great job including it)

HIPAA Notice of Privacy Practices

Effective Date: [Insert Date]

This Notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

Our Responsibilities

Empower Women’s Health, PLLC is required by law to:

  • Maintain the privacy of your protected health information (PHI)

  • Provide you with this Notice

  • Follow the terms of this Notice

How We May Use and Disclose Your PHI

We may use and disclose your PHI for:

  • Treatment: Providing and coordinating your medical care

  • Payment: Billing, collections, and payment processing

  • Healthcare Operations: Quality assessment, administrative functions

Other disclosures may occur as required by law or with your written authorization.

Your Rights

You have the right to:

  • Access and receive a copy of your medical records

  • Request corrections to your health information

  • Request restrictions on certain uses or disclosures

  • Request confidential communications

  • Receive a list of disclosures

  • Receive a copy of this Notice

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. You will not be retaliated against.

Contact for Privacy Matters

Privacy Officer
Empower Women’s Health, PLLC
📧 lauren@empower-womens-health.com
📍 Blacksburg, VA