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.

Effective date: October 20, 2026

One Vein Clinic is required by law to protect the privacy of your health information. This notice explains how we may use and share it, your rights, and our responsibilities. It applies to all records of your care at One Vein Clinic.

Your rights

When it comes to your health information, you have the right to:

• Get a copy of your medical record. You can see or get a paper or electronic copy of your medical and billing records. We’ll usually provide it within 30 days of your request. We may charge a reasonable, cost-based fee.
• Ask us to correct your record. If you think information is wrong or incomplete, you can ask us to change it. We may say no, but we’ll tell you why in writing within 60 days.
• Ask for confidential communication. You can ask us to contact you in a specific way (for example, only on your cell phone) or at a different address. We will say yes to all reasonable requests.
• Ask us to limit what we use or share. You can ask us not to use or share certain information for treatment, payment, or our operations. We don’t have to agree if it would affect your care. If you pay for a service in full out of pocket, you can ask us not to share that information with your health insurer, and we will say yes unless the law requires us to share it.
• Get a list of who we’ve shared information with. You can ask for a list of the times we’ve shared your information in the past six years, who we shared it with, and why. It won’t include sharing for treatment, payment, or operations, or sharing you asked us to make. The first list in any 12 months is free; we may charge a reasonable fee for more.
• Get a copy of this notice. You can ask for a paper copy at any time, even if you agreed to receive it electronically.
• Choose someone to act for you. If someone is your medical power of attorney or legal guardian, they can exercise your rights. We’ll confirm they have this authority first.
• File a complaint if you think your rights were violated. See “Complaints” below. We will not retaliate against you for filing a complaint.

To use any of these rights, contact our Privacy Officer using the details at the end of this notice.

Your choices

For some information, you can tell us your choices about what we share. Tell us what you want and we’ll follow your instructions.

• Family and friends: You can tell us whether we may share information with family, close friends, or others involved in your care or payment. If you can’t tell us (for example, if you’re unconscious), we may share information if we believe it’s in your best interest, and we’ll give you a chance to object afterward.
• Disaster relief: You can tell us whether we may share information with disaster relief organizations.

We will never share your information for these purposes unless you give us written permission:

• Marketing
• Sale of your information
• Most sharing of psychotherapy notes

How we use and share your information

We typically use or share your health information in these ways:

• To treat you. We use your information and share it with other professionals who are treating you. Example: your primary care doctor asks about your vein treatment.
• To run our practice. We use your information to run our clinic, improve your care, and contact you when needed. Example: we send you an appointment reminder, or review records to improve care quality.
• To bill for your services. We use and share your information to get paid by health plans or others. Example: we give your insurance company information about your procedure so it will pay for it.

We use service providers (“business associates”), such as billing, IT, and scheduling companies, who must protect your information under a written agreement with us.

Other ways we may share your information

We are allowed or required to share your information in other ways, usually for purposes that benefit public health or safety. We must meet many conditions in the law first.

• Public health and safety: preventing disease, reporting adverse reactions to medications or medical devices, reporting suspected abuse, neglect, or domestic violence, and preventing a serious threat to someone’s health or safety
• Research: under strict legal conditions
• When the law requires it: including to the U.S. Department of Health and Human Services to show we comply with privacy law
• Organ and tissue donation: to organ procurement organizations
• Medical examiners and funeral directors: when an individual dies
• Workers’ compensation, law enforcement, and other government requests: for workers’ compensation claims, law enforcement purposes or with a law enforcement official, health oversight agencies for audits and inspections, and special government functions such as military, national security, and presidential protective services
• Correctional institutions: if you are an inmate, as needed for your health and safety or the safety of others
• Lawsuits and legal actions: in response to a court or administrative order, or in response to a subpoena

Florida law gives extra protection to some types of information, such as HIV test results, mental health, and substance use treatment records. When state law is stricter than federal law, we follow the stricter law.

For any other use or sharing not described in this notice, we will ask for your written permission. You can take back (revoke) your permission at any time in writing, except for actions we have already taken based on it.

Our responsibilities

• We are required by law to keep your health information private and secure.
• We will tell you promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing.

Changes to this notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available on request, in our office, and on our website.

Complaints

If you believe your privacy rights have been violated, you can:

• Contact us: reach our Privacy Officer using the details below.
• Contact the U.S. Department of Health and Human Services, Office for Civil Rights: online at www.hhs.gov/ocr/complaints, by phone at 1-800-368-1019 (TDD 1-800-537-7697), or by mail at 200 Independence Avenue, S.W., Washington, D.C. 20201. Complaints to the Office for Civil Rights must generally be filed within 180 days of when you knew about the problem.

We will not retaliate against you for filing a complaint.

Contact our Privacy Officer

One Vein Clinic – Privacy Officer
206 Ashourian Ave, Suite 213
St. Augustine, FL 32092
Phone: 904-990-0777
Email: ovc@oneveinclinic.com