HIPAA Notice of
Privacy Practices
Your Information · Your Rights · Our Responsibilities
Raleigh, NC 27607
This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health condition and related health care services.
Uses & Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your physician, our office staff and others outside of our office who are involved in your care and treatment — for the purpose of providing health care services to you, paying your health care bills, supporting the operation of the physician’s practice, and any other use required by law.
Treatment
We will use and disclose your PHI to provide, coordinate, or manage your health care and related services, including coordination with third parties such as referred physicians to ensure proper diagnosis or treatment.
Payment
Your PHI will be used as needed to obtain payment for your health care services — for example, disclosing information to your health plan to obtain approval for a hospital stay.
Healthcare Operations
We may use or disclose your PHI to support business activities including quality assessment, employee review, training of medical students, licensing, and other business activities. We may also contact you with appointment reminders and health-related information.
We may use or disclose your protected health information in the following situations — except SUD records as described in the February 15, 2026 addendum — without your authorization: as required by law, public health issues, communicable diseases, health oversight, abuse or neglect, FDA requirements, legal proceedings, law enforcement, coroners, funeral directors, organ donation, research, criminal activity, military activity and national security, workers’ compensation, inmates, and other required uses and disclosures.
Under the law, we must make disclosures to you upon your request, and also when required by the Secretary of HHS to investigate our compliance under Section 164.500.
Other permitted and required uses and disclosures will be made only with your consent, authorization or opportunity to object unless required by law. You may revoke your authorization at any time, in writing, except to the extent that your physician or the physician’s practice has already taken action in reliance on it.
Your Rights
The following are statements of your rights with respect to your protected health information.
You may inspect and copy your protected health information. Under federal law, certain records are excluded: psychotherapy notes; information compiled for civil, criminal, or administrative proceedings; PHI restricted by law; information related to medical research you’ve agreed to participate in; information whose disclosure may cause harm; or information obtained under a promise of confidentiality.
You may ask us not to use or disclose any part of your PHI. We must comply when the PHI pertains solely to a health care item or service paid out of pocket in full. You may also request restrictions on disclosures to family members or friends involved in your care. Note: you may not restrict disclosures for treatment purposes.
You have the right to request that we communicate with you by alternative means or at an alternative location. You also have the right to obtain a paper copy of this notice upon request, even if you have agreed to receive it electronically.
If we deny your request for amendment, you have the right to file a statement of disagreement with us. We may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
You have the right to receive an accounting of all disclosures, except those: pursuant to an authorization; for treatment, payment, or healthcare operations; required by law; that occurred prior to April 14, 2003; or more than six years before the date of your request.
You have the right to obtain a paper copy of this notice at any time, even if you agreed to receive it electronically. We reserve the right to change the terms of this notice and will notify you of changes at your next appointment.
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will verify the person has this authority before taking any action.
Filing a Complaint
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated. To file a complaint with us, please notify our Compliance Officer.
✓ We will never retaliate against you for filing a complaintAddendum to Notice of
Privacy Practices
Special Protections for Substance Use Disorder Records · 42 C.F.R. Part 2
Special Privacy Protections
We are not primarily a substance use disorder (SUD) treatment program. We may receive and maintain SUD-related information incidentally (e.g., referrals, history, meds, labs). That information may be subject to additional federal privacy protections under 42 C.F.R. Part 2, which in some cases is more restrictive than HIPAA. When these stricter rules apply, we follow them.
How We May Use and Disclose Health Information
We may use and disclose your health information for treatment, payment, and health care operations. When information includes substance use disorder records, additional legal requirements may apply — including your written consent before using or disclosing that information.
Limits on SUD Records
Federal law places strict limits on how SUD records may be used or disclosed. Substance use disorder records cannot be used or disclosed to initiate or substantiate civil, criminal, administrative, or legislative proceedings without written consent or a qualifying court order.
Authorization & Consent
Certain uses and disclosures require written authorization, which you may revoke at any time by written request, except where already relied upon. If your health information includes SUD records, your authorization may allow us to use and disclose that information for treatment, payment, and health care operations as permitted by law.
Your Rights
You have the right to inspect, access, amend, request restrictions, request confidential communications, and receive an accounting of disclosures, as permitted by law.
Redisclosure Notice
If your health information is disclosed to another party, that party may be permitted to redisclose it and it may no longer be protected by HIPAA. However, substance use disorder records may continue to be protected by federal law even after disclosure, depending on the circumstances.
De-Identified Information
We may disclose de-identified health information for public health, research, or health care operations as permitted by law. De-identified information does not identify you and cannot reasonably be used to identify you.
Fundraising Communications
We may contact you for fundraising purposes. You have the right to opt out at any time. Your decision to opt out will not affect your access to care.
Complaints & Enforcement
If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.
Changes to This Notice
We reserve the right to change this Notice of Privacy Practices at any time. Any changes will apply to all health information we maintain. The current version of this notice will be available upon request and on our website.