WEBSITE TERMS OF USE

1. Agreement; Acceptance of Terms.

A. These Website Terms of Use (the “Terms” or this “Agreement”) govern your access to and use of the website operated by Physician Within, a direct primary care medical practice owned and operated by Alia Whitman, M.D. (the “Practice,” “we,” “us,” or “our”), located at https://www.physicianwithin.com/ (the “Website”).

B. By accessing, browsing, or otherwise using the Website in any manner, you (the “User,” “you,” or “your”) acknowledge that you have read, understood, and agree to be legally bound by these Terms, as they may be modified from time to time as set forth in Section 2 (Changes to These Terms).

C. If you do not agree to these Terms, you are not authorized to access or use the Website and must immediately discontinue use.

D. You represent and warrant that:

i. You are at least eighteen (18) years of age, or the age of majority in your jurisdiction of residence, whichever is greater; and

ii. You have the legal capacity and authority to enter into this Agreement, and, if you are accessing the Website on behalf of an entity or another individual, you are authorized to bind that entity or individual to these Terms.

E. These Terms apply solely to your use of this Website. They do not govern, and are expressly separate and distinct from:

i. Any direct primary care membership or services you may receive from the Practice; or

ii. Any other professional or clinical services that may be provided by the Practice, the physician-owner, or any other licensed healthcare professional affiliated with the Practice.

iii. Any such services are governed exclusively by separate written agreements and forms, including, without limitation, the Practice’s Member or Package Agreements and any other consent or intake documents applicable to those services.

2. Changes to These Terms.

A. We reserve the right, in our sole discretion, to modify, amend, or replace these Terms, in whole or in part, at any time and from time to time.

B. Any changes to these Terms will be effective when posted on the Website or on such later date as may be specified in the revised Terms. We may, but are not obligated to, provide additional notice of material changes (for example, by posting a notice on the Website home page or sending you an email if we have your contact information).

C. It is your responsibility to regularly review these Terms for any changes. Your continued access to or use of the Website after the posting of revised Terms constitutes your binding acceptance of those changes.

D. If you do not agree with the amended Terms, you must cease all access to and use of the Website.

3. No Medical Advice.

A. The Website, including all content, text, data, graphics, images, videos, audio, information, postings, articles, blog entries, FAQs, and other materials made available on or through the Website (collectively, the “Website Content”), is provided for general informational and educational purposes only.

B. The Website Content is not intended to, and does not, constitute or substitute for medical advice, diagnosis, treatment, the practice of medicine, the practice of nursing or any other healthcare profession, or any individualized or professional health care services.

4. No Physician-Patient Relationship.

A. Your access to, or use of, the Website or any Website Content, including, without limitation, the act of sending us a message through any general contact form on the Website, does not create and is not intended to create a physician-patient relationship, doctor-patient relationship, or any other professional healthcare relationship between you and the Practice, the physician-owner, or any other healthcare professional affiliated with the Practice.

B. A physician-patient relationship with the Practice is created only in accordance with applicable law and only after you have been accepted as a patient or member by the Practice, you have completed all required intake and consent procedures, and you and the Practice have entered into, and executed, the applicable Service Agreement or other governing agreement.

C. You should never disregard professional medical advice or delay seeking it because of something you have read on, or obtained from, the Website. You should not rely on the Website or the Website Content for decisions or actions regarding your health, medical care, or any other professional services.

D. The Website may allow you to submit general inquiries or appointment requests. Such communications are not a substitute for appropriate medical evaluation and care, do not create a physician-patient relationship, and may not be monitored in real time or on a continuous basis.

E. Before acting on any information found on the Website, you should consult a qualified healthcare professional who is familiar with your specific medical condition, history, and circumstances.

5. Not for Emergencies or Urgent Situations.

A. The Website is not designed for, intended for, or appropriate for emergency or urgent medical situations, crisis situations, or time-sensitive communications requiring immediate or rapid response.

B. If you are experiencing a medical emergency or believe that you may be experiencing a medical emergency, do not use the Website. You must call 911 (or the appropriate emergency number in your jurisdiction) immediately and/or go to the nearest hospital emergency department or urgent care facility.

6. Scope of Website Use; No Service Terms.

A. These Terms govern only your access to and use of the publicly accessible portions of the Website and any informational, educational, marketing, or other non-clinical materials and features made available on or through the Website.

B. These Terms do not govern your enrollment in, or participation as, a member of any package, program, or service offered by the Practice or define, modify, or regulate the rights and obligations of the parties under any clinical services agreement.

7. Privacy; Separate Privacy Policy.

A. The Website is intended for general informational purposes and is not designed to receive or store detailed protected health information (PHI) as defined under the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations (“HIPAA”). You should not submit sensitive medical or health information via general Website forms.

B. To the extent that any information you provide to the Practice through secure patient portals or other HIPAA-compliant platforms is subject to HIPAA or other applicable privacy laws, such information will be handled in accordance with the Practices HIPAA Notice of Privacy Practices and other applicable privacy documentation, which are separate from these Terms.

8. Ownership of the Website and Intellectual Property.

A. The Website, including without limitation all Website Content, design, layout, look and feel, interfaces, software, source code, object code, compilations, and underlying data, is owned by the Practice or its licensors and is protected by United States and international copyright, trademark, trade secret, and other intellectual property or proprietary rights laws.

B. All trademarks, service marks, trade names, logos, and trade dress (collectively, “Marks”) displayed on the Website are the property of the Practice or their respective owners. You are not granted any license or right to use any Marks by virtue of your use of the Website.

9. User Conduct and Prohibited Activities.

A. As a condition of your access to and use of the Website, you agree that you will not use the Website for any purpose that is unlawful or prohibited by these Terms.

B. Without limiting the generality of the foregoing, you agree that you will not, directly or indirectly:

i. Use the Website in any manner that could interfere with, disrupt, negatively affect, or inhibit other users from fully enjoying the Website, or that could damage, disable, overburden, or impair the functioning of the Website or any servers or networks connected to the Website;

ii. Use any robot, spider, scraper, crawler, automated script, or other automated device, means, or process to access, monitor, copy, or collect data or other content from the Website for any purpose without our express prior written consent;

iii. Introduce any viruses, worms, Trojan horses, malware, or other harmful or malicious code, files, or programs designed to interrupt, destroy, limit, or otherwise harm the functionality of any software, hardware, or telecommunications equipment;

iv. Attempt to gain unauthorized access to any portion of the Website, any other systems or networks connected to the Website, or any server, including through hacking, password mining, or any other means;

v. Probe, scan, or test the vulnerability of the Website or any network connected to the Website, or breach the security or authentication measures on the Website;

vi. Circumvent, disable, or otherwise interfere with any security-related features of the Website or features that enforce limitations on the use of the Website;

vii. Use the Website for any fraudulent, unlawful, harassing, defamatory, libelous, abusive, obscene, vulgar, invasive of another’s privacy, hateful, or otherwise objectionable purpose;

viii. Impersonate any person or entity, or falsely state or misrepresent your affiliation with any person or entity, including misrepresenting that you are a patient or member of the Practice if you are not;

ix. Collect, harvest, or store personal data about others obtained through the Website, without their express consent and in violation of applicable law;

x. Use the Website in any manner that could be construed as the unauthorized practice of medicine or any other regulated profession, including offering or soliciting medical advice or treatment to or from other users;

xi. Use the Website in violation of any applicable local, state, national, or international law, regulation, or professional standard.

C. We reserve the right, in our sole discretion and without notice, to terminate or restrict your use of the Website if we believe you have engaged in any prohibited activity or otherwise violated these Terms, or for any other reason or no reason, subject to applicable law.

10. No Warranties; Disclaimers.

A. You expressly acknowledge and agree that your use of the Website and Website Content is at your sole risk.

B. TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, THE WEBSITE AND WEBSITE CONTENT ARE PROVIDED “AS IS” AND “AS AVAILABLE,” WITHOUT WARRANTIES OF ANY KIND, WHETHER EXPRESS, IMPLIED, OR STATUTORY, INCLUDING WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, NON-INFRINGEMENT, OR ACCURACY. NOTHING IN THESE TERMS SHALL EXCLUDE WARRANTIES THAT CANNOT BE DISCLAIMED UNDER APPLICABLE LAW.

C. Any reliance on or use of any Website Content is at your own discretion and risk. You are solely responsible for verifying the accuracy, completeness, and applicability of any Website Content before relying on it.

D. The Website may contain typographical errors, inaccuracies, or omissions, and the Practice reserves the right to correct any such errors, inaccuracies, or omissions and to change or update information at any time without prior notice.

E. The Website may contain links to third-party websites or resources. Such links are provided solely for convenience. The Practice does not endorse and is not responsible for the content, accuracy, availability, products, services, or privacy practices of any third-party websites.

11. Limitation of Liability.

A. To the maximum extent permitted by applicable law, in no event shall the Practice, the physician-owner, or their respective owners, officers, directors, employees, contractors, agents, licensors, or affiliates be liable for any indirect, incidental, special, consequential, exemplary, or punitive damages; loss of profits, revenue, goodwill, data, or other intangible losses; business interruption or inability to use the Website arising out of or in connection with your access to or use of, or inability to access or use, the Website.

B. To the maximum extent permitted by applicable law, the total aggregate liability of the Practice, the physician-owner, and their respective owners, officers, directors, employees, contractors, agents, licensors, and affiliates, for any and all claims arising out of or relating to these Terms or your access to or use of the Website shall not exceed one hundred dollars (US $100.00).

C. Nothing in these Terms shall exclude or limit liability for fraud, intentional misconduct, willful misconduct, reckless conduct, or any liability that cannot be excluded or limited under applicable Ohio law. Otherwise, the foregoing limitations shall apply to the fullest extent permitted by law.

12. Availability; Suspension; Termination.

A. The Practice reserves the right, in its sole discretion, to modify, suspend, or discontinue the Website, in whole or in part, at any time and for any reason, with or without notice, or restrict, suspend, or terminate your access to and use of the Website, in whole or in part, at any time and for any reason or no reason, including, without limitation, for any violation of these Terms.

B. Termination or suspension of your access to the Website will not limit or affect any other rights or remedies available to the Practice at law or in equity.

C. Sections that, by their nature, should survive termination of these Terms shall survive any such termination.

13. Dispute Resolution; Time Limit to Bring Claims.

A. If you have a dispute with the Practice relating to the Website or these Terms, you agree to first contact the Practice using the contact information provided in Section 14 and to attempt to resolve the dispute informally.

B. To the fullest extent permitted by applicable law, any claim arising out of or relating to these Terms or the Website must be commenced within one (1) year after the claim accrues; provided, however, that if Ohio law requires a longer limitations period for a particular claim, the applicable statutory limitations period shall control. Otherwise such cause of action or claim is permanently barred.

14. Miscellaneous.

A. Entire Agreement. These Terms, together with the Notice of Privacy Practices and any other legal notices or additional terms posted on the Website and expressly incorporated by reference, constitute the entire agreement between you and the Practice with respect to the subject matter hereof and supersede all prior or contemporaneous understandings, agreements, negotiations, and communications, whether written or oral, relating to such subject matter.

B. Severability. If any provision of these Terms is held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, such provision shall be enforced to the maximum extent permissible, and the remaining provisions of these Terms shall continue in full force and effect.

C. No Waiver. No waiver by the Practice of any term or condition set forth in these Terms shall be deemed a further or continuing waiver of such term or condition or a waiver of any other term or condition. Any failure of the Practice to assert a right or provision under these Terms shall not constitute a waiver of such right or provision.

D. Assignment. You may not assign, transfer, or delegate any of your rights or obligations under these Terms, by operation of law or otherwise, without the prior written consent of the Practice. The Practice may assign, transfer, or delegate any or all of its rights and obligations under these Terms without restriction and without notice to you.

E. Relationship of the Parties. Nothing in these Terms shall be construed to create any partnership, joint venture, agency, fiduciary, employment, or other relationship between you and the Practice. You are an independent user of the Website and not an employee, agent, or partner of the Practice.

F. Consumer Rights. Nothing in these Terms is intended to waive any rights or remedies that may not be waived under applicable federal or Ohio law.

G. Electronic Communications. By using the Website or communicating with the Practice electronically, you consent to receive communications electronically. You agree that all agreements, notices, disclosures, and other communications provided electronically satisfy any legal requirement that such communications be in writing.

H. Headings. The headings in these Terms are for convenience only and shall not affect the interpretation of these Terms.

I. Interpretation. As used in these Terms, the words “include,” “includes,” and “including” are deemed to be followed by the phrase “without limitation.” The singular includes the plural and vice versa, as the context may require.

J. Notices. The Practice may provide you with notices, including notices regarding changes to these Terms, by posting such notices on the Website, by email (if you have provided an email address), or by any other reasonable means. Notices shall be deemed given:

i. If sent by certified mail, return receipt requested, upon confirmation of delivery;

ii. If sent by nationally recognized overnight courier, upon confirmation of delivery;

iii. If sent by email, upon confirmation that the email has been transmitted without error (provided that a hard-copy backup may also be requested).

K. Governing Law. This Agreement and any dispute arising out of or relating to these Terms or your access to or use of the Website shall be governed by and construed in accordance with the laws of the State of Ohio without giving effect to its conflict of laws principles.

L. Contact Information. If you have any questions about these Terms or the Website, or if you wish to report any violation of these Terms, you may contact the Practice at:

PHYSICIAN WITHIN

85 EXECUTIVE PKWY STE 203

HUDSON, OH 44236

Location

Physician Within
85 Executive Parkway
Suite 203
Hudson, OH 44236

Hours

Monday — Friday
as above

Contact

info@physicianwithin.com
(234) 380-6564

Text: (234) 380-6564 *

*Please allow 48hrs to reply

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NOTICE OF PRIVACY PRACTICES

As Required by the Privacy Regulations Created as a Result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU (AS A PATIENT OF THIS PRACTICE) MAY BE USED AND DISCLOSED, AND HOW YOU CAN GAIN ACCESS TO YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION.

PLEASE REVIEW THIS NOTICE CAREFULLY.

A. OUR COMMITMENT TO YOUR PRIVACY:

Our practice is dedicated to maintaining the privacy of your individually identifiable health information (IIHI). In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We are also required by law to provide you with this notice of our legal duties and the privacy practices that we maintain in our practice concerning your IIHI. By federal and state law, we must follow the terms of the notice of privacy practices that we have in effect at the time.

We realize that these laws are complicated, but we must provide you with the following important information:

· how we may use and disclose your IIHI

· your privacy rights in your IIHI

· our obligations concerning the use and disclosure of your IIHI

The terms of this notice apply to all records containing your IIHI that are created or retained by our practice. We reserve the right to revise or amend this Notice of Privacy Practices. Any revision or amendment to this notice will be effective for all of your records that our practice has created or maintained in the past, and for any of your records that we may create or maintain in the future. Our practice will always post the current Notice in our office, on our website, and will provide you with a copy upon request. When we make a significant change to this Notice, we will post a revised Notice before it becomes effective.

B. IF YOU HAVE QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT:

Physician Within

Attn: Privacy Officer

85 Executive Parkway, Ste 203

Hudson, OH 44236

(234) 380-6564

C. WE MAY USE AND DISCLOSE YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (IIHI) IN THE FOLLOWING WAYS:

The following categories describe the different ways in which we may use and disclose your IIHI, unless you object:

1. Treatment. Our practice may use your IIHI to treat you. For example, we may ask you to have laboratory tests (such as blood or urine tests), and we may use the results to help us reach a diagnosis. We might use your IIHI in order to write a prescription for you, or we might disclose your IIHI to a pharmacy when we order a prescription for you. Many of the people who work for our practice—including, but not limited to, our doctors and nurses—may use or disclose your IIHI in order to treat your or to assist others in your treatment. Addition ally, we may disclose your IIHI to others who may assist in your care, such as other healthcare providers, your spouse, your children or your parents.

2. Payment. Our practice may use and disclose your IIHI in order to bill and collect payment for the services and items you may receive from us. We will use or disclose only the minimum necessary information except where a broader use is required by law or for treatment. For example, we may use and disclose your IIHI to obtain payment from third parties that may be responsible for such costs, such as family members. Also, we may use your IIHI to bill you directly for services and items.

3. Health Care Operations. Our practice may use and disclose your IIHI to operate our business, but we will use or disclose only the minimum necessary information except where a broader use is required by law or for treatment. As examples of the ways in which we may use and disclose your information for our operations, our practice may use your IIHI to evaluate the quality of care you received from us, to develop protocols and clinical guidelines, to develop training programs, and to aid in credentialing, medical review, legal services and insurance. We will share information about you with such insurers or other business associates as necessary to obtain these services.

4. Appointment Reminders. Our practice may use and disclose your IIHI to contact you and remind you of an appointment.

5. Treatment Options. Our practice may use and disclose your IIHI to inform you of potential treatment options or alternatives.

6. Health-Related Benefits and Services. Our practice may use and disclose your IIHI to inform you of health-related benefits or services that may be of interest to you. You may opt-out of these communications by giving us notice.

7. Release of Information to Family/Friends. Our practice may release your IIHI to a friend or family member that is involved in your care, or who assists in taking care of you, but we will only share this information if you agree, are given an opportunity to object and do not, or if, in our professional judgment, it is in your best interest (for example, if you are incapacitated or in an emergency).

8. Disclosures Required by Law. Our practice will use and disclose your IIHI when we are required to do so by federal, state, or local law.

D. NON-DISCLOSURE OF YOUR IIHI FOR MARKETING

We will not sell your individually identifiable health information without your written authorization. We will not use or disclose your IIHI for marketing purposes requiring authorization under HIPAA unless we first obtain your written authorization. You may revoke any authorization at any time in writing.

E. USE AND DISCLOSURE OF YOUR IIHI IN CERTAIN SPECIAL CIRCUMSTANCES:

The following categories describe unique scenarios in which we may use or disclose your identifiable health information:

1. Public Health Risks. Our practice may disclose your IIHI to public health authorities that are authorized by law to collect information for the purpose of:

· maintaining vital records, such as births and deaths;

· reporting child abuse or neglect;

· preventing or controlling disease, injury, or disability;

· notifying a person regarding potential exposure to a communicable disease;

· notifying a person regarding a potential risk for spreading or contracting a disease or condition;

· reporting reactions to drugs or problems with products or devices;

· notifying individuals if a product or device they may be using has been recalled;

· notifying appropriate government agency(ies) and authority(ies) regarding the potential abuse or neglect of an adult patient (including domestic violence); however, we will only disclose this information if the patient agrees or we are required or authorized by law to disclose this information; or

· notifying your employer under limited circumstances related primarily to workplace injury or illness or medical surveillance. Such disclosures occur only as authorized by law and, when required, after informing the individual.

2. Health Oversight Activities. Our practice may disclose your IIHI to a health oversight agency for activities authorized by law. Oversight activities can include, for example, investigations, inspections, audits, surveys, licensure and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the health care system in general.

3. Lawsuits and Similar Proceedings. Our practice may use and disclose your IIHI in response to a court or administrative order if you are involved in a lawsuit or similar proceeding. We also may disclose your IIHI in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.

4. Law Enforcement. We may release IIHI if asked to do so by a law enforcement official:

· regarding a crime victim in certain situations, if we are unable to obtain the person’s agreement;

· concerning a death we believe has resulted from criminal conduct;

· regarding criminal conduct at our offices;

· in response to a warrant, summons, court order, subpoena or similar legal process;

· to identify/locate a suspect, material witness, fugitive or missing person; or

· in an emergency, to report a crime (including the location or victim(s) of the crime, or the description, identity or location of the perpetrator).

5. Deceased Patients. Our practice may release IIHI to a medical examiner or coroner to identify a deceased individual or to identify the cause of death. If necessary, we may also release information in order for funeral directors to perform their jobs.

6. Organ and Tissue Donation. Our practice may release your IIHI to organizations that handle organ, eye or tissue procurement or transplantation, including organ donation banks, as necessary to facilitate organ or tissue donation and transplantation if you are an organ donor.

7. Research. Our practice may use and disclose your IIHI for research purposes in certain limited circumstances. We will obtain your written authorization to use your IIHI for research purposes except when: (a) our use or disclosure was approved by an Institutional Review Board or a Privacy Board; (b) we obtain the written agreement of a researcher that (i) the information being sought is necessary for the research study; (ii) the use or disclosure of your IIHI is being used only for the research and (iii) the researcher will not remove any of your IIHI from our practice; or (c) the IIHI sought by the researcher only relates to decedents and the researcher agrees in writing that the use or disclosure is necessary for the research and, if we request it, to provide us with proof of death prior to access to the IIHI of the decedents.

8. Serious Threats to Health or Safety. Our practice may use and disclose your IIHI when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Un der these circumstances, we will only make disclosures to a person or organization able to help prevent the threat.

9. Military. Our practice may disclose your IIHI if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate authorities.

10. National Security. Our practice may disclose your IIHI to federal officials for intelligence and national security activities authorized by law. We may also disclose your IIHI to federal officials in order to protect the President, other officials or foreign heads of state, or to conduct investigations.

11. Inmates. Our practice may disclose your IIHI to correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Disclosure for these purposes would be necessary: (a) for the institution to provide health care services to you, (b) for the safety and security of the institution, and/ or (c) to protect your health and safety or the health and safety of other individuals.

12. Workers’ Compensation. Our practice may release your IIHI for workers’ compensation and similar programs, when and if required by applicable law.

13. State Law Preemption. Certain categories of health information may receive additional protections under federal or Ohio law, including information related to mental health treatment, substance use disorder treatment records protected by 42 C.F.R. Part 2, HIV/AIDS information, genetic testing information, and other specially protected records. We will comply with all applicable laws before using or disclosing such information.

F. YOUR RIGHTS REGARDING YOUR IIHI:

The health and billing records we maintain are the physical property of Physician Within. The information in it, however, belongs to you. You have a right to:

1. Confidential Communications. You have the right to request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. In order to request a type of confidential communication, you must make a written request to the Privacy Officer, specifying the requested method of contact, or the location where you wish to be contacted. Our practice will accommodate reasonable requests. You do not need to give a reason for your request.

2. Requesting Restrictions. You have the right to request a restriction in our use or disclosure of your IIHI for treatment, payment or health care operations. Additionally, you have the right to request that we restrict our disclosure of your IIHI to only certain individuals involved in your care or the payment for your care, such as family members and friends. If you do not pay in full for a service out-of-pocket, we are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you. In order to request a restriction in our use or disclosure of your IIHI, you must make your request in writing to the Privacy Officer. Your request must describe in a clear and concise fashion:

a. the information you wish restricted;

b. whether you are requesting to limit our practice’s use, disclosure or both; and

c. to whom you want the limits to apply.

3. Self-Pay Restriction Right (HITECH). If you pay in full for a service out-of-pocket and ask us not to share information about that service with your health plan, we must agree to your request unless a law requires us to share that information.

4. Inspection and Copies. You have the right to inspect and obtain a copy of the IIHI that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to the Privacy Officer in order to inspect and/or obtain a copy of your IIHI. If your information is maintained electronically, you may request an electronic copy in a reasonable electronic form and format. Our practice may charge a reasonable, cost-based fee permitted by law for the costs of copying, mailing, labor and supplies associated with your request. Our practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of our denial. Another licensed health care professional chosen by us will conduct reviews. We will provide access to records within the time periods required by applicable federal and Ohio law.

5. Amendment. You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing and submitted to the Privacy Officer. You must provide us with a reason that supports your request for amendment. Our practice will deny your request if you fail to submit your request (and the reason supporting your request) in writing. Also, we may deny your request if you ask us to amend information that is in our opinion: (a) accurate and complete; (b) not part of the IIHI kept by or for the practice; (c) not part of the IIHI which you would be permitted to inspect and copy; or (d) not created by our practice, unless the individual or entity that created is not available to amend the information.

6. Response to Requests. We will respond to access and amendment requests within time frames required by law (e.g., 30 days with a possible extension of an additional 30 days).

7. Accounting of Disclosures. All of our patients have the right to request an “accounting of disclosures.” An “accounting of disclosures” is a list of certain non-routine disclosures our practice has made of your IIHI for non-treatment or operations purposes. Use of your IIHI as part of the routine patient care in our practice is not required to be documented. For example, the doctor sharing information with the nurse. In order to obtain an accounting of disclosures, you must submit your request in writing to the Privacy Officer. All requests for an “accounting of disclosures” must state a time period, which may not be longer than six (6) years from the date of disclosure and may not include dates before April 14, 2003. The first list you request within a 12-month period is free of charge, but our practice may charge you for additional lists within the same 12-month period. Our practice will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs.

8. Right to a Paper Copy of this Notice. You are entitled to receive a paper copy of our notice of privacy practices. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this notice, contact the Privacy Officer.

9. Right to File a Complaint. If you believe your privacy rights have been violated, you may file a complaint with us in writing, by phone, or in person. You will not be penalized for filing a complaint. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. For more information, visit www.hhs.gov/ocr/privacy/hipaa/complaints/ or call 1‑800‑368‑1019. To file a complaint with our practice, contact:

Physician Within

Attn: Privacy Officer

85 Executive Parkway, Ste 203

Hudson, OH 44236

(234) 380-6564

10. Right to Provide an Authorization for Other Uses and Disclosures. Our practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. Examples of uses and disclosures that generally require your written authorization include: most uses of psychotherapy notes, certain marketing communications, and any sale of your health information. Any authorization you provide to us regarding the use and disclosure of your IIHI may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your IIHI for the reasons described in the authorization. Your revocation will not affect any uses or disclosures that we have already made in reliance on your authorization. Please note: we are required to retain records of your care.

11. You have the right to be notified if we discover a breach of your unsecured individually identifiable health information that requires notification under applicable law. We will provide such notice in accordance with federal and state requirements.

Again, if you have questions regarding this notice or our health information privacy policies, please contact the Privacy Officer listed above.

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Privacy Policy Explanation

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At Physician Within, your privacy matters to us. We understand that your health information is deeply personal, and we’re committed to protecting it while ensuring it’s available when you and your clinicians need it. This guide highlights the key points of our privacy policy—formally called our Notice of Privacy Practices—so you’ll know exactly how your information is used, shared, and protected, and what rights you have as a member.

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How We Use and Share Your Health Information

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We use your health information to give you excellent care. This includes diagnosing and treating illness, coordinating your care with other professionals, ordering tests or prescriptions, and following up on your progress. We may also use your information to manage clinic operations, such as quality improvement, staff training, and record keeping. If applicable, we may use it for billing or administrative purposes. Physician Within will only share the minimum necessary information to perform these functions. Your information may also be shared—with your consent or as permitted by law—with trusted professionals involved in your care, such as labs, pharmacies, or specialists.

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Special Situations Where Information May Be Shared

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In certain cases, we may share information without your written authorization when required or permitted by law.

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Examples include:

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· Reporting communicable diseases or reactions to medications.

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· Responding to legal requests such as subpoenas or court orders.

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· Working with health oversight agencies (for example, audits or compliance reviews).

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· Reporting suspected abuse or neglect.

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· Responding to law enforcement requests or emergencies involving public safety.

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· Assisting with organ donation, medical research (under strict conditions), or workers’

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· compensation programs.

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Outside of these limited cases, we will always ask your permission before sharing your

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health information.

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Your Rights as a Member

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You have important rights when it comes to your health information:

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· Access and Copies: You can request a copy of your medical records or ask that they be sent to another provider.

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· Amendments: You can ask us to correct or add to information you believe is incomplete or inaccurate.

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· Restrictions: You can request limits on how we share your information or who can access it.

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· Confidential Communications: You can ask us to contact you in a specific way—such as by phone, email, or secure text—or at a specific location.

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· Accounting of Disclosures: You can request a list of certain disclosures we’ve made that weren’t related to treatment, payment, or clinic operations.

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· Authorization for Other Uses: We will obtain your written authorization before using or disclosing your information for purposes not described in this notice, and you may revoke that authorization at any time.

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· Paper Copies: You can request a printed copy of our full privacy notice at any time.

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If you’d like to exercise any of these rights, simply contact our Privacy Officer—we’ll walk you through the process.

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How We Protect Your Information

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We take your privacy seriously. We maintain appropriate administrative, technical, and physical safeguards designed to protect your information, in accordance with applicable law. Only clinicians and staff directly involved in your care or clinic operations can access your records. We use reasonable safeguards to protect your information as required by law. However, like all organizations that use electronic systems, we cannot guarantee absolute security in every circumstance.

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If You Have Concerns or Questions

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If you ever have questions about how your information is handled—or believe your privacy

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rights have been violated—you can contact our Privacy Officer directly:

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Physician Within

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Attn: Privacy Officer

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85 Executive Parkway, Ste 203

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Hudson, OH 44236

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(234) 380-6564

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You can also file a complaint with the U.S. Department of Health and Human Services. You will never be penalized for filing a complaint.

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You can request the full Notice of Privacy Practices at any time by contacting our office or visiting our website.‍

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