Notice of Privacy Practices

You may ask for a paper copy of this notice at any time. · Website Privacy Policy

Notice of Privacy Practices

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.

PEAK Wellness & Aesthetics, LLC
Originally effective June 2024; revised October 2, 2026

Your information. Your rights.

This notice explains how PEAK protects and uses your health information, your choices, and how to exercise your privacy rights. It applies to PEAK and its workforce in providing care and operating the practice, including care coordinated through our patient portal and intake services.

Your rights at a glance

You may ask to see or receive your records; request a correction; ask for confidential communications or limits on sharing; request an accounting of disclosures; obtain a paper copy of this notice; and have an authorized representative act for you. You may also file a privacy complaint without retaliation.

Questions, requests, or complaints

Contact our Privacy Officer at (757) 312-9444. You may also write to:
Privacy Officer
PEAK Wellness & Aesthetics, LLC
221 Mount Pleasant Road, Suite A
Chesapeake, VA 23322

Call for help making a request or to ask how to deliver documents securely. We may need to verify your identity and authority, and may ask you to submit certain requests in writing. You do not need to explain why you want confidential communications.

About this notice

This notice is separate from consent to treatment, permission for marketing, and an authorization to release records. An acknowledgment that you received it does not waive your privacy rights or authorize additional uses of your information.

Your privacy rights

See or receive your records

You can ask to inspect or receive a paper or electronic copy of your medical and billing records and other information used to make decisions about you. Ask the Privacy Officer for help. We will respond within the time required by applicable law, generally within 30 days. We will provide the requested format when required by law, or work with you on an available format. A summary is provided only if you agree. Any fee will be reasonable, cost-based, and permitted by law.

Virginia law also allows you to specifically request an audit trail of additions, deletions, or revisions to your record. Some information, such as separately maintained psychotherapy notes, is excluded from the access right. If we deny access, we will explain the reason in writing and any right to review the denial.

Ask for a correction

You can ask us in writing to amend information you believe is incorrect or incomplete, and explain why. We generally act within 60 days; if a permitted extension is needed, we will notify you in writing. If we deny your request, we will explain why and how you may submit a statement of disagreement.

Request confidential communications

You can ask us to contact you in a specific way, such as at a particular phone number, or at a different address. We will accommodate reasonable requests. Tell the Privacy Officer your preferred method or location.

Ask us to limit use or sharing

You can ask us not to use or share particular information for treatment, payment, or health care operations, or with people involved in your care. We usually do not have to agree. If we agree, we will follow the restriction except when disclosure is needed for emergency treatment or otherwise required by law.

If you pay for a service or item out of pocket in full, you can ask us not to disclose information about that service or item to your health plan for payment or health care operations. We must honor that request unless disclosure is required by law. Tell us before we submit a claim.

Request an accounting of disclosures

You can request a list of certain disclosures made during the six years before your request, including who received information and why. The list generally excludes disclosures for treatment, payment, operations, disclosures you authorized, and other legally excluded disclosures. One accounting in a 12-month period is free. We will tell you in advance of any permitted charge for additional requests so you can change or withdraw the request.

Your choices and permissions

Get a paper copy or choose a representative

You may request a paper copy of this notice at any time, even if you agreed to receive it electronically. We will provide it promptly. A person legally authorized to act for you, such as a health care agent or guardian, may exercise your rights within the scope of that authority. We verify the authority and follow applicable exceptions, including protections involving abuse or endangerment.

Family, friends, and disaster relief

Tell us whether we may share information with people involved in your care or payment for care, or with disaster relief organizations. We will follow your choices and any applicable requirement for written permission. If you cannot tell us your preference, we may share limited information when the law permits and our professional judgment finds it in your best interest. Separate legal rules may permit disclosure to prevent a serious and imminent threat.

Uses requiring written authorization

We obtain your written authorization for uses and disclosures for marketing when HIPAA requires it, sale of your protected health information, and most uses or disclosures of separately maintained psychotherapy notes. Other uses and disclosures not described in this notice also require your written authorization unless permitted or required by law.

You can revoke an authorization in writing by contacting the Privacy Officer. Revocation applies going forward; it does not undo actions already taken in reliance on your authorization.

Fundraising communications

If we contact you for fundraising, you may opt out of further fundraising communications. Your decision will not affect treatment or payment. Before using records protected by 42 CFR Part 2 for fundraising, we will give you a clear, conspicuous opportunity to elect not to receive those communications.

Additional protections

We follow more protective federal and Virginia requirements when they apply. In Virginia, disclosures of separately maintained psychotherapy notes generally require written authorization, with limited exceptions such as disclosures required by law, certain oversight or defense activities, training, or duties to protect others. Rules for minors may give the minor control over some records rather than a parent. We apply those rules before releasing information.

How we use and share information

The permissions below are subject to applicable legal conditions, any agreed restrictions, and the additional protections described in this notice. A permitted purpose does not give us unrestricted authority to release your records.

Treatment

We use and share health information to provide, coordinate, and manage your care. For example, a PEAK clinician may share relevant medical history with another clinician treating you or a laboratory performing an ordered test. We may contact you about appointments, treatment alternatives, or care-related services as permitted by law.

Payment

We use and share information to bill for services and obtain payment. For example, we may send a health plan information about a visit to process a claim, subject to your right to restrict disclosures for services paid out of pocket in full.

Health care operations

We use and share information to run the practice, assess quality, improve care, and support necessary business functions. For example, we may review records to evaluate care quality or resolve a billing issue. Service providers performing functions for us, such as record hosting or billing support, must protect information under applicable agreements and law.

Public health and safety

When permitted or required by law, we may disclose information to report disease, medication reactions, product problems or recalls, suspected abuse or neglect, domestic violence, or to prevent or lessen a serious and imminent threat to health or safety.

Research

Information may be used or shared for research only when legal requirements are met, such as your authorization or an approved waiver and required privacy safeguards. This notice alone does not enroll you in research.

Required by law and health oversight

We disclose information when required by law, including to the U.S. Department of Health and Human Services to check compliance with privacy law. We may disclose information for authorized oversight activities, such as audits, inspections, licensing, and investigations.

Other disclosures and our duties

Legal, government, and other permitted purposes

Subject to legal safeguards, we may disclose information in response to a court or administrative order or a qualifying subpoena or other lawful process; for certain law enforcement purposes; for workers' compensation; and for authorized military, national security, protective services, or correctional purposes. We may share information with organ procurement organizations or, after a death, with a coroner, medical examiner, or funeral director as permitted by law.

Substance use disorder records: special protection

If we receive or maintain substance use disorder patient records protected by 42 CFR Part 2, those records have additional protections. We will not use or disclose those records, or testimony describing their contents, in civil, criminal, administrative, or legislative investigations or proceedings against you unless you give the required written consent or a qualifying court order authorizes it. Before that order is issued, you or the record holder must receive notice and an opportunity to be heard as required by Part 2. The order must be accompanied by a subpoena or other legal requirement compelling disclosure.

Our responsibilities

We are required by law to protect the privacy of your protected health information, provide this notice of our duties and practices, and notify you following a breach of your unsecured protected health information as required by law. We maintain required safeguards and must follow the notice currently in effect.

Changes to this notice

We reserve the right to change this notice and make the revised terms apply to information we already maintain as well as information we receive later. The revised notice will show its effective date and will be available in our office, upon request, and on our website at peakwellnessva.com.

File a complaint without retaliation

You may complain to our Privacy Officer by calling (757) 312-9444 or writing to the address at the start of this notice. You may also complain directly to the U.S. Department of Health and Human Services, Office for Civil Rights: 200 Independence Avenue, S.W., Washington, D.C. 20201; 1-877-696-6775; or hhs.gov/hipaa/filing-a-complaint. We will not retaliate against you for filing a complaint.