Notice of Privacy Practices

Effective Date: 9/8/2026

Your Information. Your Rights. Our Responsibilities.

This Notice describes how medical information about you may be used and disclosed and how you can obtain access to this information.

Please review it carefully.

This Notice applies to protected health information maintained by Holistic Wellness Services LLC in connection with the healthcare services it provides.

HHS requires covered healthcare providers to provide a clear explanation of how protected health information may be used and disclosed, patients’ rights, the provider’s legal duties, complaint procedures, and a privacy contact.

Your Rights

You have certain rights regarding your health information.

Get a copy of your health information

You may ask to see or receive an electronic or paper copy of health information that HWS maintains about you, subject to applicable law.

HWS will generally provide access or a copy within the time required by law.

A reasonable, cost-based fee may apply where permitted.

Ask us to correct your health information

If you believe information maintained about you is incorrect or incomplete, you may ask HWS to correct it.

HWS may deny the request in certain circumstances, but will explain the reason in writing when required.

Request confidential communications

You may ask HWS to contact you in a particular way or at a particular location.

For example, you may request that HWS contact you only at a certain telephone number or email address.

HWS will accommodate reasonable requests as required by law.

Ask us to limit what we use or share

You may ask HWS not to use or disclose certain health information for treatment, payment, or healthcare operations.

HWS is not always required to agree to the request.

If you pay for a service in full out of pocket, you may ask HWS not to disclose information about that service to your health plan for payment or healthcare operations, except where disclosure is required by law.

Get a list of certain disclosures

You may request an accounting of certain disclosures of your health information made during the period permitted by law.

Some disclosures, including many disclosures made for treatment, payment, or healthcare operations, may not appear on that accounting.

Get a copy of this Notice

You may request a paper or electronic copy of this Notice at any time.

The current Notice is also available on the HWS website.

Choose someone to act for you

If you have given another person legal authority to act on your behalf, such as a legal guardian, healthcare power of attorney, or other authorized personal representative, that person may exercise your privacy rights where permitted by law.

HWS may verify the person’s authority before acting on a request.

File a complaint

You may file a complaint with HWS if you believe your privacy rights have been violated.

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

HWS will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you may tell HWS your preferences about what information may be shared.

Depending on applicable law and the circumstances, this may include:

• sharing information with family members or others involved in your care;
• sharing information in a disaster-relief situation;
• certain communications about mental-health care;
• marketing communications; and
• other uses that require your authorization.

If you are unable to communicate your preference, HWS may share information when permitted by law and when necessary in circumstances such as an emergency or to reduce a serious and imminent threat to health or safety.

How HWS May Use and Share Your Health Information

HWS may use or disclose protected health information as permitted or required by law.

Treatment

HWS may use and share health information to provide, coordinate, or manage your healthcare.

For example, information may be shared with another healthcare professional involved in your treatment when permitted by law.

Payment

HWS may use and share health information to obtain payment for healthcare services.

For example, HWS may provide information to a health insurer when necessary to process or support payment.

Healthcare operations

HWS may use and share health information to operate the practice and improve care.

Examples may include:

• quality review;
• administrative activities;
• compliance activities;
• credentialing;
• business planning;
• auditing; and
• practice management.

When required by law

HWS may disclose health information when federal, state, or local law requires it.

Public health and safety

HWS may disclose information when legally permitted or required for public-health or safety purposes, including certain situations involving:

• preventing or controlling disease;
• reporting suspected abuse or neglect;
• preventing or reducing a serious threat to health or safety; or
• other legally authorized public-health activities.

Health oversight activities

Information may be disclosed to authorized agencies for legally permitted oversight activities such as audits, investigations, inspections, or licensing activities.

Legal proceedings

HWS may disclose health information in response to a valid court or administrative order, subpoena, discovery request, or other lawful process where permitted by law.

Law enforcement

HWS may disclose information to law-enforcement authorities in circumstances allowed or required by law.

Other legally permitted uses

Other uses or disclosures may be permitted for purposes such as:

• workers’ compensation;
• certain government functions;
• medical examiner or coroner activities; or
• other circumstances specifically authorized by law.

Mental Health Information

Mental-health information may be subject to additional protections under federal or state law.

HWS will comply with applicable laws that provide greater privacy protection than HIPAA.

Certain disclosures of psychotherapy notes or specially protected records may require specific authorization except where the law provides otherwise.

Substance Use Disorder Records

If HWS maintains records subject to 42 CFR Part 2, those records receive the additional protections required by federal law. Such records will not be used or disclosed in civil, criminal, administrative, or legislative proceedings against an individual unless authorized by written consent or permitted by a qualifying court order and subpoena.

Uses and Disclosures Requiring Authorization

HWS will obtain your written authorization before using or disclosing your health information when authorization is required by law.

Examples may include certain:

• uses of psychotherapy notes;
• marketing activities;
• sales of protected health information; and
• other disclosures not otherwise permitted by law.

You may revoke an authorization in writing, subject to legal limitations regarding actions already taken in reliance on that authorization.

Our Responsibilities

HWS is required by law to:

• maintain the privacy and security of protected health information;
• provide you with this Notice;
• follow the privacy practices described in the current Notice;
• notify affected individuals when required following a breach of unsecured protected health information; and
• comply with applicable federal and state privacy laws.

HHS specifically identifies these responsibilities as required elements of the Notice.

Changes to This Notice

HWS may change the terms of this Notice.

Any revised Notice may apply to health information HWS already maintains as well as information received in the future, to the extent permitted by law.

The current notice will be available on the HWS website and upon request through the patient portal. For existing patients, a signed copy is accessible through the patient portal.

Questions or Complaints

For questions about privacy practices or to file a complaint with HWS:

Privacy Contact Holistic Wellness Services LLC

Email: inquiry@hwservices.org
Phone: 240-847-4763

You may also file a complaint with:

U.S. Department of Health and Human Services Office for Civil Rights

HHS provides complaint information through its Office for Civil Rights.

HWS will not retaliate against you for exercising your privacy rights or filing a complaint.