Effective Date: 01/01/2026
Privacy Officer Contact
Privacy OfficerRabia Akbar
Mailing Address3525 Lawrenceville-Suwanee Rd, #101, Suwanee, GA 30024
Phone770-927-8180
Fax833-764-6081
About This Notice
We are legally required to protect your Protected Health Information (PHI) and to provide you with this notice about our privacy practices. This notice outlines your rights and our responsibilities regarding your PHI. We must follow the terms of this notice.
What is Protected Health Information (PHI)?
PHI refers to information that identifies you personally and is created or received by us or other healthcare providers, health plans, employers, or clearinghouses. It relates to your physical or mental health (past, present, or future), the healthcare you receive, or payment for your healthcare.
How We May Use and Share Your PHI
For TreatmentWe use PHI to provide and coordinate your medical care, including sharing information via Health Information Exchange with other healthcare professionals involved in your treatment.
For PaymentWe use and share PHI to bill and collect payment from you, your insurance, or other payers. This may include providing information to your health plan or collection agencies if necessary.
For Healthcare OperationsWe use PHI for business activities such as staff performance reviews, cost management, audits, and legal services. We may also share PHI with other entities for their operations.
Appointment Reminders and Health InformationWe may contact you about appointments, treatment options, or health-related benefits and services.
MinorsPHI of minors may be shared with parents or guardians unless prohibited by law.
Personal RepresentativesLegal guardians or representatives are treated as the patient regarding PHI disclosures.
As Required by LawWe will share PHI when required by international, federal, state, or local laws.
To Prevent Serious ThreatsPHI may be shared to prevent serious threats to health or safety.
Business AssociatesWe may share PHI with companies that provide services for us, such as billing or consulting, under contracts requiring them to protect your information.
Organ and Tissue DonationPHI may be shared with organizations involved in organ or tissue donation.
Military and VeteransPHI may be released as required by military authorities.
Workers' CompensationPHI may be used for workers' compensation claims.
Public Health RisksPHI may be disclosed for public health activities, such as reporting diseases, child abuse, product recalls, or exposure to communicable diseases.
Health Oversight ActivitiesPHI may be shared with agencies for audits, inspections, and other oversight activities.
Lawsuits and DisputesPHI may be disclosed in response to court orders or legal processes.
Law EnforcementPHI may be released to law enforcement for specific reasons, such as locating suspects or reporting crimes.
National SecurityPHI may be shared with federal officials for national security purposes.
Coroners, Medical Examiners, and Funeral DirectorsPHI may be released to these professionals as needed.
InmatesPHI may be disclosed to correctional institutions or law enforcement if necessary for your care or safety.
Uses and Disclosures That Allow You to Object or Opt Out
Individuals Involved in Your CarePHI may be shared with family or friends involved in your care or payment, unless you object.
Disaster ReliefPHI may be shared with disaster relief organizations to coordinate care or notify loved ones, unless you object.
Uses and Disclosures Requiring Your Written Authorization
Marketing and Sale of PHIThese uses require your written permission.
Other UsesAny other use or disclosure not covered by this notice or applicable laws requires your written authorization. You may revoke your authorization at any time in writing.
Special Protections for Certain Information
Additional privacy protections apply to HIV-related information, substance abuse, mental health, and genetic data. Some parts of this general Notice of Privacy Practices may not apply to these kinds of PHI. Please contact our Privacy Officer for information about the special protections that apply.
Your Rights Regarding Your PHI
Right to Inspect and CopyYou may review or obtain copies of your PHI, except psychotherapy notes. Fees may apply. If denied, you can request a review.
Right to Electronic CopiesIf your PHI is electronic, you can request an electronic copy or transmission to another party. Fees may apply.
Right to Notice of BreachYou will be notified of any breach of your unsecured PHI.
Right to Request AmendmentsYou may request corrections to your PHI in writing, stating the reason. We may deny requests under certain circumstances.
Right to Accounting of DisclosuresYou can request a list of PHI disclosures. The first request in a 12-month period is free; additional requests may incur a fee.
Right to Request RestrictionsYou may ask us to limit how we use or share your PHI. We are not required to agree, but will comply if we do.
Right to Restrict Disclosures to Health PlansYou can restrict disclosures to health plans for services paid out-of-pocket in full.
Right to Confidential CommunicationsYou may request specific ways for us to contact you. Requests must be in writing.
Right to a Paper CopyYou may request a paper copy of this notice at any time, even if you received it electronically.
How to Exercise Your Rights
Send written requests to our Privacy Officer at the address listed above. We may ask you to complete a form.
Changes to This Notice
We may change this notice at any time. Changes apply to all PHI we have or receive in the future. The current notice is always posted in our office and on our website.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of Health and Human Services. Complaints must be in writing and submitted within 180 days of the suspected violation. There will be no retaliation for filing a complaint.