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.
VitalSigns House Calls Inc. is required by law to: maintain the privacy of your Protected Health
Information (PHI); provide you with notice of our legal duties and privacy practices with respect to
PHI; notify you following a breach of your Unsecured PHI; and abide by the terms of the Notice
currently in effect.

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1. Our Commitment to Your Privacy
VitalSigns House Calls Inc. understands that health information about you is personal and private. We
are committed to protecting your PHI. We create and maintain records of the care and services you
receive at VitalSigns. We need this record to provide you with quality care and to comply with legal
requirements. This notice tells you about the ways we may use and disclose your PHI and describes
your rights and our obligations regarding your PHI.

2. How We May Use and Disclose Your PHI
The following describes ways we may use and disclose your PHI. Not every use or disclosure will be
listed; however, all of the ways we are permitted to use and disclose information will fall within one
of these categories.
For Treatment
We may use and disclose your PHI to provide, coordinate, or manage your health care and related
services. For example, we may disclose your PHI to physicians, specialists, pharmacies,
laboratories, hospitals, home health agencies, or other providers involved in your care. As an
in-home practice, this includes sharing clinical information during care transitions, hospitalizations,
or specialist referrals.
For Payment

HIPAA NOTICE OF PRIVACY PRACTICES

VitalSigns House Calls Inc. | Mobile, Alabama | Dynamic Care Delivered Page 3
We may use and disclose your PHI to obtain payment for services provided to you. For example, we
submit claims to Medicare, Medicare Advantage plans, and other insurers that include information
about your diagnosis, treatment, and services rendered. We may also share PHI with a patient's
health plan for pre-authorization of services.
For Health Care Operations
We may use and disclose your PHI for our health care operations, including: quality assessment
and improvement activities; workforce training and supervision; credentialing and peer review;
general administrative and business management functions; and conducting or arranging for other
business activities.

3. Uses and Disclosures Requiring Your Authorization
For uses and disclosures beyond treatment, payment, and operations, we will ask for your written
authorization. This includes most uses of psychotherapy notes (if applicable), uses for marketing
purposes, and any sale of PHI. You may revoke an authorization at any time in writing, except where
we have already taken action in reliance on it.

4. Permitted Disclosures Without Authorization
We may use or disclose PHI without your authorization in limited circumstances required or
permitted by law, including:
• As Required by Law: Court orders, legal proceedings, law enforcement requests, or mandatory
public health reporting.
• Public Health Activities: Reporting communicable diseases, FDA safety activities, work-related
illness or injury reporting to employers.
• Victims of Abuse, Neglect, or Domestic Violence: As required or permitted under applicable law.
• Health Oversight Activities: Disclosures to CMS, OIG, state health departments, accreditation
bodies, and other oversight agencies.
• Research: With appropriate IRB or Privacy Board approval and applicable safeguards.
• Serious Threat to Health or Safety: To prevent or lessen a serious and imminent threat to a
person or the public.
• Specialized Government Functions: National security activities, military operations, correctional
institution activities.
• Workers' Compensation: To comply with workers' compensation laws and programs.
• Decedents: To coroners, medical examiners, or funeral directors as necessary.
• Organ and Tissue Donation: To organ procurement organizations as authorized by law.

5. Special Categories — Heightened Protections
The following categories of PHI receive heightened protections under federal and Alabama law:
• Mental Health and Substance Use Disorder Records: Governed by additional restrictions,
including 42 CFR Part 2 for substance use disorder treatment records.
• HIV/AIDS Status and Test Results: Subject to specific consent requirements under Ala. Code §
22-11A-17 et seq.
• Genetic Information: Protected under the Genetic Information Nondiscrimination Act (GINA) and
HIPAA.
• Reproductive Health Information: Subject to applicable state and federal protections.
• Minor Patient Records: Access rights governed by Alabama state law and the minor's legal
guardian.

6. Your Rights Regarding Your PHI
You have the following rights with respect to your PHI:
Right to Inspect and Copy
You may request to inspect and receive a copy of your medical records or other PHI that we
maintain. We may charge a reasonable cost-based fee for copies. We will respond to your request
within 30 days. We may deny access in limited circumstances as permitted by law.
Right to Request Amendment
If you believe that PHI we hold about you is incorrect or incomplete, you may request an
amendment. We may deny your request in certain circumstances (e.g., if the information was not
created by us). We will respond within 60 days.
Right to an Accounting of Disclosures
You may request an accounting of certain disclosures of your PHI made during the six years prior to
your request. This right does not apply to disclosures made for treatment, payment, or health care
operations.
Right to Request Restrictions
You may request that we restrict certain uses or disclosures of your PHI. We are generally not
required to agree, except that we must honor a request not to disclose PHI to a health plan if you
have paid for the service in full out of pocket and the disclosure is solely for payment purposes.
Right to Request Confidential Communications
You may request that we communicate with you about your health matters in a specific way or at
a specific location (e.g., only send mail to a P.O. Box, or only call a specific number). We will
accommodate reasonable requests.
Right to a Paper Copy of This Notice
You have the right to request a paper copy of this Notice at any time, even if you have agreed to
receive it electronically.
Right to Notification of a Breach
We are required by law to notify you without unreasonable delay — and within 60 days of discovery
— if there is a breach of your Unsecured PHI that compromises the privacy or security of your
information.

7. Our Duties Under HIPAA
• Maintain the privacy and security of your PHI as required by law.
• Provide you with notice of our legal duties and privacy practices.
• Abide by the terms of this Notice while it remains in effect.
• Not use or disclose your PHI in a manner not described in this Notice without your authorization.
• Notify you following a breach of Unsecured PHI as required by the HITECH Act.

8. Changes to This Notice
We reserve the right to change this Notice and to make the revised Notice effective for all PHI we
already maintain, as well as any information we receive in the future. The current version of this
Notice will be available on our website and in our office at all times. We will provide you with a copy
of any revised Notice at your first visit or communication following a material change.

9. Complaints
If you believe your privacy rights have been violated, you may file a complaint with VitalSigns or with
the Secretary of the U.S. Department of Health and Human Services. You will not be penalized,
retaliated against, or otherwise disadvantaged for filing a complaint.

10. Contact Our Privacy Officer and HHS

Privacy Officer — VitalSigns House Calls Inc. Mobile, Alabama
Email: privacy@vitalsignshousecalls.com U.S. Department of Health and Human Services — Office for Civil
Rights 200 Independence Avenue, S.W., Washington, D.C. 20201 Toll-Free: 1-800-368-1019 | TDD:
1-800-537-7697 OCR Complaint Portal: hhs.gov/ocr/privacy/hipaa/complaints We will NOT retaliate

against you for filing a complaint with HHS.