HIPAA Notice of Privacy Practices
Effective Date: July 13, 2026
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.
HIPAA Notice of Privacy Practices
Allevius Clinic, LLC is required by law to maintain the privacy of your protected health information (PHI), to provide you with notice of our legal duties and privacy practices with respect to your health information, and to abide by the terms of this Notice.
1. How We May Use and Disclose Your Health Information
The following describes the ways Allevius Clinic, LLC may use and disclose your protected health information without requiring your specific written authorization:
Treatment
We may use your health information to provide, coordinate, or manage your medical care. For example, we may share information with other healthcare providers involved in your treatment when clinically necessary.
Payment
We may use and disclose your health information to obtain payment for the services we provide. For example, we may submit claims to your health insurance plan, Medicare, or Medicaid.
Healthcare Operations
We may use and disclose your health information for our own healthcare operations, including quality assessment, staff training, compliance activities, and business management.
As Required by Law
We will disclose your health information when required to do so by federal, state, or local law, including reporting requirements related to public health, abuse, neglect, or law enforcement.
Business Associates
We may share your information with business associates, which are third-party vendors who perform services on our behalf, such as our telehealth scheduling platform provider (Healthie). These associates are required by contract and federal law to protect your information.
2. Uses and Disclosures Requiring Your Authorization
For uses and disclosures not described in this Notice, we will ask for your written authorization before using or sharing your health information. You have the right to revoke that authorization at any time in writing, except to the extent we have already acted in reliance on it.
We will not use or disclose your information for marketing purposes, sell your health information, or share psychotherapy notes without your written authorization.
3. Your Rights Regarding Your Health Information
Right to Access
You have the right to inspect and obtain a copy of your medical records maintained by Allevius Clinic, LLC. Requests should be submitted in writing to our office. We may charge a reasonable fee for copying and mailing.
Right to Amend
You have the right to request that we amend your health information if you believe it is inaccurate or incomplete. We may deny your request under certain circumstances but will provide a written explanation if we do so.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures we have made of your health information within the past six years, excluding disclosures made for treatment, payment, or healthcare operations.
Right to Request Restrictions
You have the right to request restrictions on how we use or disclose your health information. We are not required to agree to all requests but will accommodate reasonable ones where possible and where required by law.
Right to Confidential Communications
You may request that we communicate with you about your health information through alternative means or at an alternative location. For example, you may request that we contact you only by phone rather than email.
Right to a Paper Copy of This Notice
You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive it electronically. Please contact us to request a paper copy.
4. Our Responsibilities
Allevius Clinic, LLC is required to:
- Maintain the privacy of your protected health information
- Provide you with this Notice of our legal duties and privacy practices
- Notify you in the event of a breach of your unsecured protected health information
- Abide by the terms of the Notice currently in effect
We reserve the right to change the terms of this Notice and to make the revised Notice effective for all protected health information we maintain. We will post the current Notice on our website at www.alleviusclinic.com.
5. Complaints
If you believe your privacy rights have been violated, you may file a complaint with Allevius Clinic, LLC or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint in good faith.
To file a complaint with HHS: visit www.hhs.gov/ocr or call 1-800-368-1019.
6. Contact Information
For questions about this Notice or to exercise your rights, please contact:
Allevius Clinic, LLC - Privacy Officer
Attn: Administration
Phone: (276) 500-0338
Fax: (571) 200-2618
Email: info@alleviusclinic.com
Website: www.alleviusclinic.com