HIPAA NOTICE OF PRIVACY PRACTICES

Effective Date: July 1, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED BY OLEA FUNCTIONAL HEALTH, LLC AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

  • You can ask to see or receive an electronic or paper copy of your medical record and other health information we maintain about you.

  • We will provide a copy or summary of your health information, usually within 30 days of your request.

  • We may charge a reasonable, cost-based fee as permitted by law.

Ask us to correct your medical record

  • You may ask us to correct health information you believe is incorrect or incomplete.

  • We may deny your request, but we will explain the reason in writing within 60 days.

Request confidential communications

  • You may ask us to contact you in a specific way (for example, only by cell phone or at a different mailing address).

  • We will accommodate all reasonable requests.

Ask us to limit what we use or share

  • You may ask us not to use or share certain health information for treatment, payment, or healthcare operations.

  • We are not required to agree to every request if doing so would affect your care.

  • If you pay for a service entirely out of pocket, you may request that we not disclose information about that service to your health insurance plan. We will honor that request unless disclosure is required by law.

Get a list of disclosures

  • You may request an accounting of certain disclosures of your health information made during the six years prior to your request.

  • This list will not include disclosures made for treatment, payment, healthcare operations, or other exceptions permitted by law.

  • One accounting per 12-month period is provided free of charge. Additional requests may incur a reasonable fee.

Get a copy of this notice

You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.

Choose someone to act for you

If you have granted someone medical power of attorney or if someone is your legal guardian, that individual may exercise your rights and make decisions regarding your health information. We will verify that person's authority before taking any action.

File a complaint if you believe your rights have been violated

If you believe your privacy rights have been violated, you may contact us directly:

Olea Functional Health, LLC

409 South 22nd Street, Suite C (inside Dynamic Wellness Studio)

Heath, OH 43056

Phone: (740) 527-3266

Email: info@oleafunctionalhealth.com

You may also file a complaint with:

U.S. Department of Health and Human Services
Office for Civil Rights

200 Independence Avenue SW

Washington, DC 20201

1-877-696-6775

https://www.hhs.gov/ocr/privacy/hipaa/complaints/

We will never retaliate against you for filing a complaint.

Your Choices

For certain health information, you have the right to tell us your preferences regarding what we share.

You may choose whether we:

  • Share information with your family members, close friends, or others involved in your care.

  • Share information during disaster relief efforts.

If you are unable to communicate your preferences—for example, if you are unconscious—we may share information when we believe it is in your best interest or when necessary to lessen a serious and imminent threat to health or safety.

We will never use or disclose your health information without your written authorization for:

  • Marketing purposes

  • Sale of your information

  • Most disclosures of psychotherapy notes

If you authorize us to use or disclose your information, you may revoke that authorization at any time in writing.

Our Uses and Disclosures

Treatment

We use your health information to provide, coordinate, and manage your healthcare.

Example: We may share information with another healthcare provider involved in your care.

Healthcare Operations

We may use your health information to operate our practice, improve the quality of care we provide, communicate with you regarding your care, and manage our business operations.

We may communicate with you by telephone, secure patient portal, email, or text message regarding appointments, follow-up care, billing, prescription questions, and other healthcare-related matters. We use reasonable safeguards to protect your privacy during electronic communications.

Payment

We may use your health information to process payments for services you receive and, when requested by you, prepare documentation such as superbills that you may submit to your health insurance company for possible reimbursement.

Olea Functional Health is a direct-pay practice and does not bill insurance companies directly.

Telehealth

We may provide healthcare services through secure telehealth technology. Information collected during telehealth visits is protected in the same manner as information obtained during in-person visits.

Other Uses and Disclosures Permitted or Required by Law

We may use or disclose your health information when permitted or required by law, including:

Public Health Activities

  • Preventing disease

  • Reporting adverse reactions to medications

  • Reporting suspected abuse, neglect, or domestic violence

  • Helping with product recalls

  • Preventing or reducing serious threats to health or safety

Research

We may use or disclose health information for research when permitted by law.

Compliance with Law

We will disclose information when required by federal, state, or local law, including compliance reviews conducted by the U.S. Department of Health and Human Services.

Organ and Tissue Donation

We may disclose health information to organ procurement organizations.

Medical Examiners and Funeral Directors

We may disclose information to coroners, medical examiners, or funeral directors when authorized by law.

Workers' Compensation, Law Enforcement, and Government Requests

We may disclose health information:

  • For workers' compensation claims

  • For certain law enforcement purposes

  • To health oversight agencies

  • For military, national security, or other specialized government functions as authorized by law

Lawsuits and Legal Proceedings

We may disclose health information in response to a court order, subpoena, or other lawful legal process.

Our Responsibilities

We are required by law to:

  • Maintain the privacy and security of your protected health information.

  • Notify you promptly if a breach occurs that may have compromised the privacy or security of your information.

  • Follow the privacy practices described in this Notice.

  • Provide you with a copy of this Notice.

We will not use or disclose your information for purposes not described in this Notice without your written authorization. If you authorize us to do so, you may revoke that authorization at any time by notifying us in writing.

Changes to This Notice

We reserve the right to change the terms of this Notice. Any revisions will apply to all protected health information we maintain. The most current version will be available:

Olea Functional Health, LLC

409 South 22nd Street, Suite C (inside Dynamic Wellness Studio)

Heath, OH 43056

Phone: (740) 527-3266

Email: info@oleafunctionalhealth.com

Website: https://oleafunctionalhealth.com