Notice of Privacy Practices

Effective date: August 27, 2026

Your rights

Get an electronic or paper copy of your medical record

You may ask to inspect or receive an electronic or paper copy of your medical record and other health information we maintain about you. We generally will provide a copy or summary within the time required by law. We may charge a reasonable, cost-based fee where permitted.

Ask us to correct your medical record

You may ask us to correct health information you believe is incorrect or incomplete. We may deny the request in some circumstances, but we will explain the reason in writing within the time required by law.

Request confidential communications

You may ask us to contact you in a particular way, such as at a specific phone number, or to send mail to a different address. We will accommodate reasonable requests.

Ask us to limit what we use or share

You may ask us not to use or disclose certain health information for treatment, payment or health care operations. We are not required to agree to most requests. If you pay for an item or service in full out of pocket, you may ask us not to disclose information about it to your health plan for payment or operations, and we will honor the request unless disclosure is required by law.

Receive a list of disclosures

You may ask for an accounting of certain disclosures of your health information made during the six years before your request. The accounting does not include every disclosure, such as most disclosures for treatment, payment and health care operations.

Get a copy of this notice

You may request a paper copy at any time, even if you agreed to receive the notice electronically.

Choose someone to act for you

If you have given someone medical power of attorney, or if someone is your legal guardian or authorized personal representative, that person may exercise your rights and make choices about your health information as allowed by law.

File a complaint without retaliation

You may complain if you believe your privacy rights have been violated. Contact Jay Medical Clinic using the information below or file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

Your choices

For certain health information, you may tell us your preferences about what we disclose. These choices may include sharing information with family, friends or others involved in your care; sharing information in a disaster-relief situation; and including information in a facility directory if one is maintained. If you cannot tell us your preference, we may disclose information when we believe it is in your best interest and as permitted by law.

We will obtain written authorization before using or disclosing your information for most marketing purposes, selling your information, or using most psychotherapy notes. If the clinic conducts fundraising, you may opt out of further fundraising communications.

How we may use and disclose health information

Treat you

We may use and disclose your health information to physicians, practitioners and other professionals who are treating you or coordinating your care.

Operate the clinic

We may use and disclose information to run the practice, improve care, train staff, manage services, conduct quality activities and contact you when necessary.

Bill for services

We may use and disclose information to bill health plans or other responsible payers and obtain payment for services provided to you.

Other permitted or required purposes

Law may permit or require uses and disclosures for public health and safety activities, reporting suspected abuse or neglect, preventing or reducing a serious threat, health oversight, research under applicable safeguards, organ and tissue donation, medical examiners and funeral directors, workers’ compensation, law enforcement, correctional institutions, military and national security activities, judicial or administrative proceedings, and other purposes required by law.

Special privacy protections

Some records may receive additional protection under federal or Florida law. As reflected in the 2026 HHS model notice, records subject to 42 CFR Part 2 concerning substance use disorder treatment have specific protections. Such records generally may not be used in civil, criminal, administrative or legislative proceedings against a patient without the patient’s written consent or a qualifying court order.

Our responsibilities

• We must maintain the privacy and security of protected health information.
• We will notify affected individuals as required if a breach compromises the privacy or security of their information.
• We must follow the notice currently in effect.
• We will not use or disclose information other than as described here unless you authorize it in writing. You may revoke an authorization in writing, except to the extent we have already relied on it.
• We may change this notice and make the revised notice effective for information we already maintain and information we receive in the future. The current notice will be available at the clinic and on this website.

Reference: HHS February 2026 model notices.