Privacy Policy
🌿 Notice of Privacy Practices
Effective Date: October 2025
Your Information • Your Rights • Our Responsibilities
This notice explains how your medical information may be used and disclosed, and how you can access this information.
We value your privacy and are committed to protecting your personal health information in accordance with federal law (HIPAA).
Your Rights
You have the right to:
Get a copy of your paper or electronic medical record.
Request corrections if your record is inaccurate or incomplete.
Request confidential communication (for example, by alternate phone number or email).
Ask us to limit what we use or share regarding your health information.
Request a list of times we’ve shared your information, who we shared it with, and why.
Receive a copy of this privacy notice at any time.
Choose someone to act for you, such as a legal guardian or healthcare representative.
File a complaint if you believe your privacy rights have been violated.
Your Choices
You have control over how certain information is shared. You may:
Tell us whether or not to share information with family, friends, or others involved in your care.
Decide whether your information may be used for marketing purposes.
Request limits on information shared after your passing.
Revoke permission at any time if you previously allowed your information to be used or shared for purposes not described here.
Our Uses and Disclosures
We typically use or share your health information in the following ways:
Treatment
We may use your information to provide, coordinate, or manage your care.
Example: We may share information with another healthcare provider involved in your treatment or to offer appropriate recommendations.
Payment
We may use and share your health information to bill and receive payment from health plans or other entities.
Example: We may share necessary information with your insurance company for reimbursement.
Healthcare Operations
We may use and share your information to run our practice, improve your care, and communicate with you as needed.
Example: We use health information to assess service quality and for administrative purposes.
Other Uses and Disclosures
We may also use or share your information as required by law or for:
Public health and safety (to prevent disease, report adverse reactions, etc.)
Health oversight (for audits, compliance, or investigations)
Legal and law enforcement requests (such as responding to court orders or subpoenas)
Workers’ compensation, disability, or other government programs
Research approved through proper review
Compliance with federal, state, or local law
We will never sell your information or use it for marketing without your written authorization.
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 compromise your privacy.
We must follow the practices described in this notice and provide you with a copy upon request.
We will not use or share your information other than as described here unless you give written permission.
Changes to This Notice
We may update this notice at any time. The revised version will apply to all information we have about you and will be available upon request and posted in our office and on our website.
Complaints
If you believe your privacy rights have been violated, you can file a complaint with:
Privacy Officer
Shia Ames, L.Ac., LLC
(805) 900-0014
📧 info@shiaameslac.com
Or with the U.S. Department of Health & Human Services Office for Civil Rights:
www.hhs.gov/ocr/privacy/hipaa/complaints/
We will not retaliate against you for filing a complaint.
Contact
If you have any questions about this notice or your privacy rights, please contact:
Shia Ames, L.Ac.
(805) 900-0014
📧 info@shiaameslac.com
Would you like me to create a shorter summary version too — for example, one you could post in your clinic or footer section (like “We protect your privacy under HIPAA. Read our full notice here →”)?