HIPAA Notice of Privacy Practices

Charlotte Weight Loss and Wellness Clinic

Effective Date: May 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Charlotte Weight Loss and Wellness Clinic is committed to protecting the privacy and confidentiality of your health information as required by the Health Insurance Portability and Accountability Act (HIPAA).

Our Responsibilities

We are required by law to:

Maintain the privacy and security of your protected health information (PHI)

Provide you with this Notice of our legal duties and privacy practices

Follow the terms of this Notice currently in effect

Notify you promptly if a breach occurs that may compromise the privacy or security of your information

How We May Use and Disclose Your Information

We may use or disclose your health information for the following purposes:

Treatment

We may use your information to provide, coordinate, or manage your healthcare services.

Example:

Discussing your treatment plan

Prescribing medications

Coordinating referrals or laboratory testing

Payment

We may use your information to bill and receive payment from health plans or other entities.

Example:

Insurance billing

Eligibility verification

Claims processing

Healthcare Operations

We may use your information for clinic operations and quality improvement activities.

Example:

Staff training

Quality assurance

Business management

Appointment reminders

Appointment Reminders and Communication

We may contact you by:

phone

voicemail

text message

email

regarding:

appointments

follow-ups

treatment information

clinic updates

Message and data rates may apply for text messaging.

As Required by Law

We may disclose your information when required by federal or state law.

Example:

Public health reporting

Court orders

Law enforcement requests

Preventing serious threats to health or safety

Your Rights

You have the right to:

Access Your Records

You may request copies of your medical records.

Request Corrections

You may request corrections to information you believe is inaccurate or incomplete.

Request Confidential Communications

You may request that we contact you in a specific way or at a specific location.

Request Restrictions

You may request limitations on certain uses or disclosures of your information.

Obtain a Copy of This Notice

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

File a Complaint

If you believe your privacy rights have been violated, you may file a complaint without fear of retaliation.

Our Commitment to Your Privacy

We will never sell your personal health information.

We will only use or disclose your information as permitted or required by law.

Contact Information

Charlotte Weight Loss and Wellness Clinic

1220 Eastway Drive, Suite C

Charlotte, NC 28205

Phone: (980) 306-2060

Email: [email protected]

Complaints

You may file a complaint with:

U.S. Department of Health and Human Services

Office for Civil Rights

https://www.hhs.gov/hipaa

We will not retaliate against you for filing a complaint.