Notice of Privacy Practices

This notice explains how your health information may be used, disclosed, and how you can access it. Please read carefully.

OUR COMMITMENT TO YOUR PRIVACY

At Roots Wellness DPC ("we," "us," or "our"), we prioritize the protection of your personal health information. Your health records are considered Protected Health Information (PHI), and we are dedicated to safeguarding this information.

We may share your PHI with healthcare providers and institutions directly involved in your care to ensure comprehensive treatment. We also share your information as needed for billing, payment collection, and the smooth operation of our practice. Our staff is trained to handle your PHI confidentially and with care. Outside of the instances described below, we will not disclose your information unless you sign a Medical Record Release Authorization.

HOW WE USE AND SHARE YOUR PHI

We may use or disclose your PHI in the following situations without requiring your authorization. While this list is not exhaustive, it includes common uses:

• To provide, coordinate, or manage your care: For example, your healthcare providers will review your medical records to plan treatment, order tests, and prescribe medications. We may share your PHI with other professionals involved in your care.

• For billing and payment purposes: We may send your information to your employer, insurance companies, or third parties to process payments for the services you receive.

• To improve our services: We may use your PHI to evaluate the quality of care you receive and improve our practice.

• To remind you of appointments and provide health-related information: We may use your PHI to send appointment reminders or share information on treatment options and wellness programs that may interest you.

• For health and safety purposes: This includes reporting adverse reactions to medications, notifying you of product recalls, or reporting abuse or neglect to appropriate authorities.

• To comply with legal requirements: We may share your PHI in response to a court order, subpoena, or as required by law enforcement in specific situations.

YOUR RIGHTS REGARDING YOUR PHI

You have the right to:

• Request a copy of your medical records: You can ask for a paper or electronic copy of your medical records by submitting a Medical Record Authorization form. We will provide it within 30 days.

• Request corrections to your medical records: If you believe your medical records are inaccurate or incomplete, you can ask for an amendment. If we deny your request, we will notify you in writing.

• Request limitations on the sharing of your PHI: You may request that certain information not be shared for treatment or billing purposes.

• Request specific communication methods: If you prefer communication by email, SMS, or another method, you can let us know.

• Request an accounting of disclosures: You can ask for a list of instances where your PHI has been shared in the past 6 years.

• Request a paper copy of this notice: You can ask for a printed copy of our Notice of Privacy Practices at any time.

• Appoint someone to make decisions for you: If you have a legal guardian or someone you trust, they can make decisions regarding your medical records.

Breach Notification

If we ever experience a breach of your PHI, we will notify you in writing no later than 60 days after discovering the breach. We take all necessary steps to protect your PHI, including working with outside entities that assist with payment and healthcare operations.

CHANGES TO THIS NOTICE

We are required by law to keep your health information private. We will abide by the terms of this notice, but we reserve the right to update or modify it as necessary. You will receive a copy of any revised notice at any of our locations.

Effective Date: July 9th, 2025

Roots Wellness DPC Code of Conduct

To maintain a safe and welcoming environment for all, we ask that patients, family members, and anyone present during your treatment adhere to the following guidelines:

• Respect for Provider and Staff: Your visit may be discontinued if necessary personnel (e.g., legal guardian) are not present, or if there are safety concerns (e.g., interference from pets or other individuals during home visits).

• Address Concerns Promptly: If you have concerns or questions about your care, please discuss them directly with your provider before they leave. For telemedicine visits, you may send a message via text or email to address any issues.

• Prepare for Your Appointment: In order to provide the best care, we ask that you communicate any concerns before your appointment so we can allocate appropriate time for discussion. Failure to do so may require rescheduling.

• Discuss Program Details: For questions regarding services, fees, or agreements, please contact us via email or phone. We are happy to provide clarification.

• Zero-Tolerance Policy: Aggressive, harassing, or violent behavior, whether verbal or physical, toward the provider or any staff member will not be tolerated.

• Cell Phones and Devices: Please silence or set your phone to vibrate during your visit and avoid using it unless necessary.

• No Recording: Audio or video recording during visits is not permitted.

Prohibited Behaviors:

• Displaying firearms or weapons of any kind

• Intimidation or harassment of any form

• Threats of violence (physical or verbal)

• Physical assault or threats of harm

• Destruction of property

• Making derogatory comments, racial slurs, or culturally offensive remarks

Violation of these policies may result in the termination of care with Roots Wellness DPC.

COMPLAINTS

If you have any questions about this notice or believe that your privacy rights have been violated, please reach out to us at:

Email: RootsWellnessDPC@gmail.com