NOTICE OF PRIVACY PRACTICES

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Send Slim Clinic Operated by Affection Health Care LLC

Effective Date: December, 12, 2025

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 Duties

We are required by law to:

  • Keep your protected health information (“PHI”) private.
  • Give you this Notice that explains our legal duties and privacy practices.
  • Follow the terms of this Notice currently in effect.
  • Notify you if a breach occurs that may have compromised the privacy or security of your PHI.

“Protected health information” or “PHI” is information about you, including basic details such as your name and contact information, that can identify you and that relates to your past, present, or future physical or mental health or condition, and related health care services.

We may change our privacy practices from time to time. If we do, we will update this Notice and post the new Notice on our website at www.sendslim.com. The new Notice will apply to all PHI we maintain at that time.

How We May Use and Disclose Your PHI

The law permits us to use and disclose your PHI for certain purposes without your specific written permission. Below are examples; not every possible use or disclosure is listed.

1. For Treatment

We may use and disclose your PHI to provide, coordinate, or manage your health care and related services.

Examples:

  • A SendSlim clinician reviews your medical history and lab results to create a weight-loss treatment plan.
  • We share information with a laboratory to order tests.
  • We may share information with another provider, such as your primary care clinician or a specialist, involved in your care.

This may include telehealth services provided by phone or video.

2. For Payment

We may use and disclose your PHI to obtain payment for services we provide.

Examples:

  • We send information about your visit to you or your health plan to seek payment, if applicable.
  • We use PHI to prepare bills, statements, and receipts.

Even if we do not bill insurance on your behalf, we may provide documentation you can submit to your health plan.

3. For Health Care Operations

We may use and disclose your PHI for health care operations, which help us run our practice and improve our services.

Examples:

  • Quality assessment and improvement activities.
  • Training and supervision of staff.
  • Accreditation, licensing, and auditing.
  • Business planning and management.

Other Uses and Disclosures We May Make Without Your Authorization

We may also use or disclose your PHI without your written authorization for the following purposes, as allowed by law:

1. Individuals Involved in Your Care or Payment

We may share limited information with a family member, friend, or other person you identify as being involved in your care or payment, if it is directly relevant to that person’s involvement.

If you are not available or are unable to agree or object (for example, in an emergency), we may use professional judgment to determine whether sharing information is in your best interest.

2. Appointment Reminders and Health-Related Benefits

We may use your contact information to:

  • Remind you of appointments.
  • Tell you about treatment alternatives or health-related services that may be of interest to you.

3. As Required by Law

We will disclose your PHI when required by federal, state, or local law.

4. Public Health and Safety Activities

We may disclose PHI for public health and safety purposes, such as:

  • Preventing or controlling disease, injury, or disability.
  • Reporting adverse events with medications or products.
  • Notifying people who may have been exposed to a disease.

5. Health Oversight Activities

We may disclose PHI to health oversight agencies for activities authorized by law, such as audits, investigations, inspections, and licensure actions.

6. Lawsuits and Legal Actions

We may disclose PHI in response to:

  • A court or administrative order.
  • A subpoena, discovery request, or other lawful process, when allowed by law.

7. Law Enforcement

We may disclose PHI to law enforcement officials in certain situations, such as:

  • In response to a court order, warrant, or summons.
  • To identify or locate a suspect, fugitive, material witness, or missing person.
  • About a crime victim, crime on our premises, or to report a crime in an emergency.

8. Coroners, Medical Examiners, and Funeral Directors

We may disclose PHI to coroners, medical examiners, or funeral directors as needed to carry out their duties.

9. Organ and Tissue Donation

If you are an organ donor, we may disclose PHI to organizations involved in organ procurement or transplantation.

10. Research

We may use or disclose PHI for research purposes in limited circumstances and usually only if the research has been reviewed and approved by an institutional review board or privacy board, or if you authorize it.

11. To Avert a Serious Threat to Health or Safety

We may use or disclose PHI when necessary to prevent or lessen a serious and imminent threat to your health or safety, or the health or safety of others, if allowed by law.

12. Specialized Government Functions

In certain situations, we may disclose PHI for specialized government functions such as:

  • Military and veterans’ activities.
  • National security and intelligence activities.
  • Protective services for the President and others.

13. Workers’ Compensation

We may disclose PHI as authorized by workers’ compensation laws and other similar programs that provide benefits for work-related injuries or illness.

Uses and Disclosures That Require Your Authorization

Certain uses and disclosures of your PHI require your written authorization. These include, in most cases:

  • Psychotherapy notes (if any are maintained separately).
  • Marketing communications where we receive financial payment from a third party for the communication, except for limited face-to-face or small promotional items.
  • Sale of PHI, meaning any disclosure where we receive financial payment in exchange for your PHI, except in situations allowed by law.

If you provide written authorization for us to use or disclose your PHI, you may revoke that authorization in writing at any time. Your revocation will not affect any use or disclosure that has already occurred based on your prior authorization.

Your Rights Regarding Your PHI

You have the following rights with respect to your PHI. To exercise these rights, please contact us using the information at the end of this Notice.

1. Right to Inspect and Obtain a Copy

You have the right to inspect and obtain a copy of certain PHI we maintain about you, in paper or electronic form, with limited exceptions (for example, psychotherapy notes or information compiled for legal proceedings).

We may charge a reasonable fee for the cost of copying, mailing, or preparing your records. In some situations, we may deny your request, but you may have the right to have the denial reviewed.

2. Right to Request an Amendment

If you believe that your PHI is incorrect or incomplete, you may request an amendment.

  • Your request must be in writing and explain why the PHI should be changed.
  • We may deny your request in certain situations, such as when we believe the information is accurate as is or we did not create the information.

If your request is denied, you may submit a written statement of disagreement, which we will add to your record.

3. Right to an Accounting of Disclosures

You have the right to request an “accounting of disclosures,” which is a list of certain disclosures of your PHI we have made in the past six years. This does not include all disclosures, such as those made:

  • For treatment, payment, and health care operations.
  • Directly to you or with your authorization.
  • For certain law enforcement or national security purposes.

We will provide one accounting in a 12-month period at no charge; we may charge a reasonable fee for additional requests.

4. Right to Request Restrictions

You have the right to request that we limit how we use or disclose your PHI for treatment, payment, or health care operations, or to certain individuals involved in your care.

We are not required to agree to most requested restrictions. If we do agree, we will follow the restriction, except in emergencies or as otherwise permitted by law.

You do have the right to request that we not disclose PHI to your health plan about a service or item for which you (or someone on your behalf) have paid us in full out of pocket, if the disclosure is for payment or health care operations and is not required by law. We will honor this type of request unless a law requires us to share the information.

5. Right to Request Confidential Communications

You have the right to request that we communicate with you in a certain way or at a certain location.

Examples:

  • Asking us to call you at a specific phone number.
  • Asking us to send mail to a different address.

We will accommodate reasonable requests.

6. 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 agreed to receive it electronically. You may request a copy from our office or download it from www.sendslim.com.

7. Right to Notice of a Breach

If a breach occurs that may have compromised the privacy or security of your PHI, we will notify you as required by law.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us and/or with the U.S. Department of Health and Human Services (HHS), Office for Civil Rights.

We will not retaliate against you for filing a complaint.

To file a complaint with us or to ask questions about this Notice, please contact us using the information below.

To file a complaint with HHS, you can contact:

Office for Civil Rights
U.S. Department of Health and Human Services
(Information is available at www.hhs.gov/ocr)

Contact Information

If you have questions about this Notice or want to exercise any of your privacy rights, you may contact us at:

SendSlim Clinic
Operated by Affection Health Care LLC
Modesto, California, USA

You may also use the contact information listed on our Contact page at www.sendslim.com