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At BelleSante, Our Mission is to inspire you to achieve your optimal Beauty & HealthSpan goals through a personalized and comprehensive approach.
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Kristine Romine, MD, FAAD
Sara Romine, DNP, FNP-C
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HIPAA Policies

Effective Date: February 2025

This Notice describes how your Protected Health Information (PHI) may be used and disclosed and how you can access this information. Please review it carefully.

Our Commitment to Your Privacy: We are committed to protecting the privacy of your medical information as required by the Health Insurance Portability and Accountability Act (HIPAA). This notice explains your rights regarding the privacy of your medical information and how we may use and disclose your information for treatment, payment, and healthcare operations. It also describes how we may use and disclose your medical information for other purposes and your rights regarding your medical information. While we do not accept insurance and may not be classified as a HIPAA-covered entity, we voluntarily follow HIPAA-aligned privacy and security best practices to protect your information.

Uses and Disclosures of Your Medical Information:
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We may use and disclose your medical information for the following purposes:

  1. Treatment: We may use and disclose your PHI to provide and coordinate your healthcare. This includes sharing information with physicians, nurses, specialists, pharmacists, or other healthcare professionals involved in your care.
  2. Healthcare Operations: We may use and disclose your PHI for our operational purposes such as:
    1. Quality improvement and patient safety initiatives.
    2. Staff training.
    3. Business and administration functions.
  3. Appointment Reminders and Health-Related Communications: We may contact you via phone, email, text message, or mail to remind you of appointments or provide healthcare information relevant to your treatment. These communications may include voicemail messages that others could potentially access.
  4. Required by Law: We may disclose your PHI when required by federal or state law, including:
    1. Public health reporting of communicable disease or adverse reactions to medications/treatments.
    2. Mandatory reporting of abuse, neglect, or domestic violence under Arizona law.
    3. Compliance with court orders, subpoenas, or law enforcement investigations.
  5. Disclosures to Family, Caregivers, or Responsible Parties: Under Arizona Revised Statues § 36-509, we may disclose your PHI to family members, caregivers, or individuals involved in your care when appropriate, unless you object. This includes:
    1. Information directly relevant to their involvement in your healthcare.
    2. PHI necessary for payment of your healthcare.
    3. PHI used for notification purposes in case of emergency.

If you do not want us to share your information with a particular individual, you must notify us in writing.

  1. Authorization for Other Uses: We will obtain your written authorization before using or disclosing your PHI for purposes not described in this Notice. You may revoke an authorization at any time in writing, except where we have already relied on it.

Your Rights Regarding Your Medical Information:
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As a patient, you have the following rights concerning your PHI:

  1. Right to Access: You have the right to review and obtain a copy of your medical records, except for certain exclusions. Requests must be made in writing, and fees may apply as permitted under Arizona Revised Statues §12-2295.
  2. Right to Request Restrictions: You may request that we limit how your PHI is used or disclosed. While we are not required to agree to all requests, we will comply if feasible.
  3. Right to Amend: If you believe your PHI is inaccurate or incomplete, you have the right to request an amendment. Requests must be in writing and include a reason for the amendment. We may deny the request, but you will receive an explanation in writing.
  4. Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures of your PHI made by us, excluding those made for treatment, payment, or healthcare operations.
  5. Right to Request Confidential Communication: You may request that we communicate with you in a specific way (e.g., only by mail or at a different phone number).
  6. Right to File a Complaint: If you believe your privacy rights have been violated, you have the right to file a complaint with us or with the Office of Civil Rights (www.hhs.gov/ocr). We will not retaliate against you for filing a complaint.

Our Responsibilities:
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Under HIPAA and Arizona Revised Statutes § 36-509, we are legally required to:

  1. Maintain the privacy and security of your PHI.
  2. Provide you with this Notice of Privacy Practices.
  3. Notify you in case of a breach of unsecured PHI.
  4. Comply with the terms outline in this Notice.

We reserve the right to change our privacy practices as described in this Notice. Any changes will apply to medical information we already have about you, as well as any information we receive in the future.

Contact Information:
For any questions about this notice or your privacy rights, please contact:

Stephanie Griffiths
8952 E Desert Cove Ave
Suite E114
Scottsdale AZ, 85260
480-878-0087

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