Notice of Privacy Practices (HIPAA)
Effective Date: July 7th, 2025
Last Updated: October 6, 2026
Our Responsibilities
We adhere to legal and ethical standards to keep your protected health information (PHI) private and to provide you with this notice of our practices, duties, and your rights. We must follow the practices described here while this notice is in effect. We may revise our privacy practices at any time, and the changes will apply to all PHI we maintain, including information created before the change. You may request a copy of the current notice at any time.
How We Use and Share Your Information
We may use or disclose your PHI for:
Treatment – To coordinate and provide your medical care. For example, sharing information with specialists, labs, pharmacies, or other providers involved in your care.
Payment – To obtain payment for your care, including insurance authorizations, coverage verification, or billing activities.
Healthcare Operations – For quality improvement, staff training, licensing, or business functions such as billing and transcription. We may also contact you for appointment reminders, treatment alternatives, or services that may interest you.
Other uses or disclosures require your written authorization, which you may revoke in writing at any time.
Additional Disclosures Permitted by Law
We may disclose your PHI in specific circumstances, including:
To family or caregivers involved in your care, only with your explicit consent.
For research (in limited, approved cases).
To coroners, funeral directors, or organ donation organizations.
To public health authorities for reporting abuse, neglect, communicable diseases, or safety concerns.
To oversight agencies for audits, investigations, or licensing.
As required by law, including law enforcement requests, court orders, or workers’ compensation claims.
To the FDA for product safety, recalls, or reporting adverse events.
Your Rights
You have the right to:
Access – View or request copies of your PHI (fees may apply).
Amend – Request corrections to your records (with certain exceptions).
Accounting – Request a list of disclosures of your PHI, except those related to treatment, payment, and operations.
Restrictions – Request limits on how we use or share your PHI (we are not always required to agree).
Confidential Communications – Request contact by alternative methods or locations.
Electronic/Written Copy – Request this notice in writing if you received it electronically.
Questions or Complaints
If you have questions about our privacy practices you may contact us directly:
Name of Contact Person: Holly Valentine- Revolution Wellness
Telephone: 225-245-9355
Fax: 225-536-9355
Address: 37283 Swamp Rd. Suite 1102 Prairieville, LA 70769
If you believe your privacy rights have been violated, you may contact us or you can file a complaint with the U.S. Department of Health and Human Services Office by calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.