Notice of Privacy Practices

III. How Your Information May Be Used or Shared Without Your Authorization

Certain uses and disclosures of PHI do not require your written permission. These include:

A. Treatment, Payment, and Healthcare Operations

We may use and disclose your PHI without your explicit consent for:

- Medical Care – Sharing information with healthcare providers to diagnose, treat, and manage your care, including remote telehealth services.

- Billing & Payment – Using PHI to process payments for services, including transactions handled by secure third-party payment processors.

- Operational Functions – Using PHI to improve service quality, train healthcare providers, and conduct internal reviews.

Additionally, we may share PHI with other healthcare professionals involved in your care if required for treatment, billing, or compliance purposes.

B. Disclosures to Family Members, Caregivers, or Trusted Individuals

If you are present and capable, we may share your PHI with a family member, friend, or caregiver involved in your care, provided:

- You agree to the disclosure.

- You are given the chance to object and do not do so.

- We reasonably assume you do not object.

If you are unavailable due to an emergency or incapacity, we may disclose PHI when, in our professional judgment, it is in your best interest. We will only share relevant information necessary for their involvement in your care or payment of services.

C. Public Health & Safety

We may share your PHI when required by law to:

- Report diseases, injuries, or conditions to public health authorities.

- Notify government agencies about child abuse, neglect, or domestic violence.

- Comply with Food and Drug Administration (FDA) reporting requirements.

- Alert individuals who may have been exposed to contagious diseases.

D. Victims of Abuse or Domestic Violence

If we reasonably believe you are a victim of abuse or neglect, we may share your PHI with government agencies authorized to intervene. We will only do so if:

- You agree, or

- Disclosure is required or permitted by law.

E. Government Oversight & Compliance

Your PHI may be disclosed to regulatory agencies responsible for overseeing healthcare operations, such as those enforcing Medicare, Medicaid, or FDA compliance.

F. Legal & Judicial Requests

We may provide PHI if required by a court order, subpoena, or other legal process.

G. Law Enforcement Authorities

We may share PHI with law enforcement officials when:

- Required by law.

- Needed to identify or locate a suspect, witness, or missing person.

- Investigating criminal activity.

H. After Death

We may release PHI to coroners, medical examiners, or funeral directors as needed.

I. Research & Medical Advancements

We may use or disclose PHI for research purposes, provided an Institutional Review Board (IRB) or Privacy Board approves the request, in accordance with applicable privacy laws.

J. Health & Public Safety Risks

We may disclose PHI to prevent or reduce serious threats to public health or individual safety.

K. Military & National Security Purposes

Your PHI may be disclosed to government agencies for military, intelligence, or security-related activities when authorized by law.

L. Workers’ Compensation Claims

If you are injured at work, we may disclose PHI as necessary to comply with workers’ compensation laws.

M. Other Legally Required Disclosures

In addition to the above, we may share PHI when required by federal, state, or local laws.

IV. Situations Requiring Your Written Permission

Some uses and disclosures of your PHI require your signed authorization, including:

A. Marketing & Sale of Health Information

We will not sell your PHI or use it for marketing purposes without your written permission, unless permitted by law.

B. Disclosure of Highly Sensitive Information

Certain categories of PHI receive additional legal protection, including:

- Mental health records.

- Substance use treatment details.

- HIV/AIDS status.

- Sexually transmitted infections (STIs).

- Genetic testing results.

- Reports of abuse or neglect.

We will not share this information without your explicit consent unless required by law.

V. Your Right to Withdraw Permission

You may revoke your written authorization at any time by submitting a request in writing. Revocation does not affect any disclosures made prior to your request.

VI. Your Rights Regarding Your Health Information

You have several rights concerning your PHI:

A. Requesting More Information or Filing a Complaint

If you believe your privacy rights have been violated, you may contact us at [email protected]. You may also file a complaint with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

B. Requesting Additional Privacy Restrictions

You can request limits on how we use or share your PHI, but we are not always required to agree unless the request concerns:

- Disclosure to a health plan when you have paid out-of-pocket in full.

C. Confidential Communications

You may request to receive communications about your PHI at an alternative address, phone number, or email.

D. Accessing and Reviewing Your Records

You can request a copy of your medical and billing records. If access is denied in limited situations, we will provide an explanation.

E. Requesting Corrections to Your Records

If you believe your PHI is incorrect, you may request an amendment. We may deny requests in certain cases but will provide a written explanation.

F. Obtaining a List of Disclosures

You have the right to request an accounting of disclosures of your PHI over the past six years, except for those made for treatment, payment, or healthcare operations.

G. Requesting a Copy of This Notice

You may request a physical or electronic copy of this Notice of Privacy Practices at any time.

VII. Changes to This Notice

We may update this Notice at any time. The revised version will apply to all PHI, including information collected before the change. The latest version will always be available on our website.

VIII. Contact Information

For privacy-related concerns, you can contact our Privacy Office at:

Evolve Privacy Office:

5521 Bellaire Drive South #200

[email protected] (Enter in subject line: Attn: Privacy Office)