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Effective Date: [Insert Date]

This Notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Our Responsibilities

Tight and Tone Wellness Center is required by law to:

  • Maintain the privacy of your Protected Health Information (PHI)

  • Provide you with this Notice explaining our legal duties and privacy practices

  • Notify you if there is a breach of your unsecured PHI

  • Follow the terms of this Notice until it is replaced or updated

How We May Use and Disclose Your PHI

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

Treatment – We may share your PHI with other healthcare professionals involved in your care.

Payment – We may use and share your PHI to bill and receive payment for the services you receive.

Healthcare Operations – We may use your PHI to operate our practice, improve services, and ensure quality care.

As Required by Law – We may disclose your PHI when required to do so by federal, state, or local laws.

Public Health and Safety – We may share your PHI for purposes such as preventing disease, reporting suspected abuse or neglect, or preventing a serious threat to health or safety.

Other Uses and Disclosures

We will not use or share your PHI for marketing, fundraising, or selling your information without your written authorization. Any other use or disclosure not described in this Notice will require your signed permission.

You may revoke your authorization at any time in writing, except to the extent that we have already taken action based on it.

Your Rights Regarding Your PHI

You have the right to:

  • Access – Request to review or receive a copy of your health records

  • Amend – Ask us to correct information you believe is inaccurate

  • Restrict Use – Request limits on how we use or share your PHI

  • Confidential Communications – Request that we contact you in a specific way (e.g., at home, by email)

  • Accounting of Disclosures – Request a list of certain disclosures we have made about your PHI

  • Receive a Copy of This Notice – You may request a copy at any time

Changes to This Notice

We may change this Notice at any time. Any updates will apply to all PHI we maintain and will be available on our website and in our office.

Contact Information

If you have questions about this Notice or believe your privacy rights have been violated, please contact us:

Tight and Tone Wellness Center
📍 TIGHT & TONE Wellness Center,Kennesaw, GA 30144
📧 info.tightandtonewellnesscenter.com
📞 (678) 508-6189

You may also file a complaint with the U.S. Department of Health & Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

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