Effective Date: Nov 3,2025
Phoenix Vitality, located in Leipsic, OH is committed to safeguarding the privacy and security of your protected health
information (PHI) as required by the Health Insurance Portability and Accountability Act (HIPAA) and its implementing
regulations. This HIPAA Privacy Policy Statement outlines our policies and procedures regarding the use, disclosure, and
protection of your PHI. Please review this statement carefully.
1. Purpose of PHI Use and Disclosure
We collect, use, and disclose your PHI only for purposes related to your healthcare and for other purposes permitted by
HIPAA. Such purposes may include treatment, payment, and healthcare operations. We may also use your PHI for other
purposes with your written authorization or as required or permitted by law.
2. Your Rights
You have certain rights regarding your PHI under HIPAA, including the right to:
– Request access to your PHI.
– Request an amendment to your PHI.
– Request an accounting of disclosures.
– Request restrictions on the use and disclosure of your PHI.
– Request confidential communication of your PHI.
– Receive notice of a breach of your unsecured PHI.
– File a complaint about our privacy practices.
To exercise these rights, please contact our designated Privacy Officer.
3. Disclosure of PHI
We will only disclose your PHI as necessary for authorized purposes, including treatment, payment, healthcare operations,
and as required or permitted by law. We may also share your PHI with our business associates, provided they have signed
appropriate agreements to protect your PHI.
4. Security Measures
We maintain physical, electronic, and procedural safeguards to protect your PHI. Access to your PHI is restricted to
authorized personnel who have a need to know. We regularly conduct risk assessments and ensure compliance with HIPAA
regulations.
5. Notice of Privacy Practices
We provide a Notice of Privacy Practices that explains your rights and our privacy practices. This notice is available upon
request and is posted in our facilities and on our website.
6. Complaints
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer at Info@Company
Name or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.
7. Changes to this Privacy Policy
We reserve the right to amend this HIPAA Privacy Policy Statement at any time. Any changes will be effective for all PHI we
maintain, including information created or received before the effective date of the changes.
8. Contact Information
For questions, requests, or complaints related to this HIPAA Privacy Policy Statement, please contact our Privacy Officer at:
Privacy Officer
Stephanie Rodriguez
Phoenix Vitality
603 East Main St, Leipsic, OH 45856
Phone: 419-957-9737
Email: phoenixvitality@outlook.com
This HIPAA Privacy Policy Statement is effective as of the date mentioned above and is subject to periodic review and
revision. Please visit our website or contact our Privacy Officer for the most current version of this statement.