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Effective Date: October 1, 2012
Last Updated: January 15, 2025
Revolution Health & Wellness Clinic is committed to protecting the privacy of your health information. This notice describes how we may use and disclose your Protected Health Information (PHI) and your rights under the Health Insurance Portability and Accountability Act (HIPAA).
We may use or share your PHI in the following ways:
Treatment: To provide and coordinate your medical care.
Payment: To bill you, your insurance company, or other responsible parties.
Healthcare Operations: For clinic management, quality improvement, training, and compliance.
As Required by Law: When disclosure is mandated by federal, state, or local law.
Any other use of your information requires your written authorization. You may revoke such authorization at any time in writing.
You have the right to:
Access and obtain copies of your health records.
Request corrections if information is incomplete or inaccurate.
Request restrictions on how we use or share your PHI (though we may not always be able to honor them).
Request confidential communications (e.g., via a specific phone number or email).
Receive a list (accounting) of disclosures we have made of your PHI.
File a complaint if you believe your rights have been violated.
We maintain physical, electronic, and administrative safeguards to secure your PHI, including:
Encrypted electronic communications.
Secure patient portals and servers.
HIPAA training for all staff members.
Limited access based on job duties.
Contact Forms: Information submitted through forms is used only to respond to your request.
Cookies and Analytics: Our site may use cookies to improve performance, but these do not collect PHI.
Patient Portal: Access requires secure login credentials.
We may use third-party services (e.g., billing or telehealth providers). All such vendors are bound by Business Associate Agreements (BAAs) and are required by law to protect your PHI.
If you believe your privacy rights have been violated, you can file a complaint with:
Privacy Officer
Revolution Health & Wellness Clinic
1008 West Taft Ave.
Sapulpa, OK 74066
(918) 935-3636
or with the:
U.S. Department of Health & Human Services (HHS), Office for Civil Rights
https://www.hhs.gov/ocr/privacy/hipaa/complaints/
We will not retaliate against you for filing a complaint.
If you have any questions about this policy or your rights, please contact our Privacy Officer at the information above.
