Notice of Privacy Practices

Alleviate Allergy Clinic · Erica L. Elliott, FNP-C

Effective date: October 23, 2026

Alleviate Allergy Clinic ("we," "us") is required by law to maintain the privacy of your protected health information ("PHI"), to give you this Notice of our legal duties and privacy practices, and to follow the terms of the Notice currently in effect. PHI is information that may identify you and that relates to your past, present, or future physical health, the health care we provide you, or payment for that care.

How we may use and disclose your health information

For treatment

We use your PHI to provide, coordinate, and manage your care — for example, reviewing your intake form before your visit, or sharing information with your primary care provider, pharmacy, laboratory, or a specialist involved in your care (with your preference on PCP sharing respected as indicated on your intake).

For payment

We may use your PHI to bill and collect payment for services — for example, processing your form-review fee or service payment through our payment processor, or providing you a receipt or superbill. As a concierge practice we do not bill insurance, but we may provide you documentation you can submit to your insurer or use with HSA/FSA accounts.

For health care operations

We may use your PHI to run the practice — for example, quality review, compliance, scheduling and appointment reminders, and communicating with you by the method(s) you authorized on your intake form.

Uses and disclosures that do not require your authorization

• When required by law, including reporting to public health authorities (such as communicable disease reporting), and reporting suspected abuse or neglect.
• Health oversight activities such as audits, licensure, and inspections.
• Judicial and administrative proceedings in response to a court order, subpoena, or lawful process.
• Law enforcement in limited circumstances defined by law.
• To avert a serious threat to your health or safety or that of another person.
• Workers' compensation as authorized by law.
• Coroners, medical examiners, funeral directors, and organ procurement as permitted by law.

Uses and disclosures that require your written authorization

Most uses and disclosures of psychotherapy notes (not applicable to our practice), uses and disclosures of PHI for marketing purposes, and any sale of PHI require your written authorization. Other uses and disclosures not described in this Notice will be made only with your written authorization, which you may revoke at any time in writing (except to the extent we have already relied on it).

Your rights regarding your health information

• Right to inspect and copy. You may request access to your medical record and receive a copy (electronic or paper). We may charge a reasonable, cost-based fee.
• Right to amend. If you believe information in your record is incorrect or incomplete, you may request an amendment in writing, with a reason.
• Right to an accounting of disclosures. You may request a list of certain disclosures we have made of your PHI outside of treatment, payment, and operations.
• Right to request restrictions. You may request limits on how we use or disclose your PHI. We are not required to agree, except we must agree not to disclose PHI to your health plan for services you (or someone on your behalf) paid for in full out of pocket, where the disclosure would be for payment or operations and is not otherwise required by law.
• Right to confidential communications. You may ask that we contact you in a specific way (for example, only by email, or only at a certain number), and we will accommodate reasonable requests.
• Right to a paper copy of this Notice. You may request a paper copy at any time, even if you agreed to receive it electronically. This page can also be printed or saved as a PDF using the buttons above.
• Right to be notified of a breach. We will notify you if a breach occurs that compromises the privacy or security of your unsecured PHI.

Our duties

We are required by law to maintain the privacy and security of your PHI, to provide you this Notice, to abide by its terms, and to notify you following a breach of unsecured PHI. We reserve the right to change this Notice and to make the revised Notice effective for PHI we already hold; the current Notice will always be posted on our website with its effective date.

Telehealth

Our care is delivered primarily by telehealth using secure video and phone technology. The same privacy protections described in this Notice apply to information collected and shared during telehealth visits and through our secure intake and communication tools.

Complaints and questions

If you believe your privacy rights have been violated, you may file a complaint with us and with the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.