Notice of Privacy Practices (NPP)
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.
Effective Date: July 23, 2026
Practice Name: Rebalance Wellness, LLC
Address: 1106 Red Bud Rd NE, Calhoun, GA 30701
Phone: (706) 943-3831 | Fax: (706) 960-6962
1. Our Commitment to Your Privacy
At Rebalance Wellness, LLC, we are committed to protecting the privacy and confidentiality of your Protected Health Information (PHI). PHI includes individually identifiable information regarding your health history, medical conditions, treatment plans, diagnostic test results, or financial/billing records.
Federal law (the Health Insurance Portability and Accountability Act - HIPAA) and Georgia state law require us to:
Maintain the privacy and security of your protected health information.
Provide you with this Notice detailing our legal duties and privacy practices.
Abide by the terms of the Notice currently in effect.
Notify you promptly if a breach occurs that compromises the privacy or security of your unencrypted PHI.
2. How We May Use and Disclose Your Health Information
We may use and disclose your PHI for the following routine healthcare purposes without needing specific written authorization:
Treatment
We use your PHI to provide, coordinate, or manage your healthcare services. This includes:
Performing medical evaluations, physical exams, and clinical consultations.
Ordering and interpreting diagnostic blood panels or laboratory testing.
Prescribing medications and coordinating with licensed 503A/503B compounding pharmacies.
Collaborating with delegating physicians under Georgia protocol agreements or referring you to specialists as clinically necessary.
Payment
As a cash-based practice, we use your PHI to process payments, maintain credit card authorizations, collect outstanding balances, or issue superbills upon request. While we do not bill commercial health insurance, Medicaid, or Medicare directly, payment information is processed securely through HIPAA-compliant merchant systems.
Healthcare Operations
We use your PHI to support the administrative, operational, and quality improvement activities of our practice, including:
Internal quality evaluations, provider performance reviews, and clinical auditing.
Managing secure electronic health records (EMR) through OptiMantra.
Facilitating secure patient communications and appointment scheduling through Spruce Health.
Compliance reviews and staff training.
3. Disclosures Required by Law or Under Special Circumstances
We may disclose your PHI without your authorization under specific legal or public safety conditions:
Georgia PDMP Registry: In compliance with Georgia law, authorized prescribers access the Georgia Prescription Drug Monitoring Program (PDMP) to review controlled substance prescription histories.
Delegating Physician Supervision: In accordance with Georgia law (O.C.G.A. § 43-34-25), clinical records may be reviewed by our delegating physician as part of routine medical protocol oversight.
Public Health & Safety: To report communicable diseases, report adverse medication reactions to the FDA, or prevent/lessen a serious, imminent threat to health or safety.
Judicial & Administrative Proceedings: In response to a court order, subpoena, or administrative summons.
Law Enforcement & Government Oversight: To health oversight agencies for audits, investigations, licensure checks, or law enforcement purposes as required by law.
4. Uses & Disclosures Requiring Your Written Authorization
Any other uses or disclosures not described in this Notice will be made ONLY with your explicit written consent, which you may revoke in writing at any time. Specifically:
Marketing & Media Release: We will never use your clinical photos, testimonial statements, or personal information for public promotional materials, website features, or social media without your prior written Marketing Release.
Sale of PHI: Rebalance Wellness, LLC will never sell your protected health information to third parties.
Discussion with Designated Family/Friends: We will only discuss your medical care or billing details with individuals you explicitly designate on your Authorization to Discuss Protected Health Information (PHI) form.
5. Your Individual Rights Regarding Your Health Information
Under HIPAA regulations, you have the following rights:
Right to Inspect and Copy Medical Records
You have the right to inspect and obtain an electronic or paper copy of your medical chart, treatment notes, and billing records. Requests must be submitted in writing. We will provide access within 30 days and may charge a reasonable, cost-based fee for paper copies or digital media.
Right to Request Amendments
If you feel that medical information in your record is incorrect or incomplete, you may request a written amendment. We may deny your request if the record was not created by us, is accurate and complete, or is not part of the legal medical record. If denied, we will provide a written explanation.
Right to Request Restrictions
You have the right to request restrictions on how we use or disclose your PHI for treatment, payment, or healthcare operations. While we are not required to agree to all restriction requests, we must agree if you pay for a service entirely out-of-pocket in full and request that we not disclose info about that service to a health plan.
Right to Confidential Communications
You have the right to request that we communicate with you via specific methods (e.g., text messaging, secure portal, email) or at alternate contact locations. We will accommodate all reasonable requests.
Right to an Accounting of Disclosures
You have the right to request a list (accounting) of certain disclosures of your PHI made by us for purposes other than treatment, payment, healthcare operations, or disclosures made pursuant to your written authorization.
Right to Receive Breach Notification
You have the right to be notified in writing following any discovery of a security breach involving your unencrypted protected health information.
Right to a Paper Copy of This Notice
You may request a physical paper copy of this Notice at any time, even if you previously agreed to receive it electronically.
6. Complaints & Privacy Officer Contact Information
If you believe your privacy rights have been violated, or if you disagree with a decision we made regarding access to your records, you may file a complaint with us directly or with the federal government:
Filing a Complaint with Rebalance Wellness, LLC:
Contact our Privacy Officer in writing or by phone:
Rebalance Wellness, LLC — Attn: Privacy Officer
1106 Red Bud Rd NE, Calhoun, GA 30701
Phone: (706) 943-3831
Filing a Complaint with the U.S. Department of Health and Human Services (HHS):
You may file a written complaint with the Office for Civil Rights (OCR) by mail, fax, or online via the HHS OCR Complaint Portal.
Non-Retaliation Policy: Rebalance Wellness, LLC strictly prohibits any form of retaliation against patients who exercise their rights or file a privacy complaint.
7. Changes to This Notice
We reserve the right to revise or change the terms of this Notice of Privacy Practices at any time. Any changes will apply to all PHI we maintain. Updated notices will be posted on our website and made available at our clinic upon request.
8. Website Visitor Privacy & Digital Data
In addition to protecting your medical information under HIPAA, Rebalance Wellness, LLC respects your digital privacy when interacting with our website.
• Automated Data Collection: Standard non-personally identifiable information (such as browser type, device info, IP address, and pages visited) may be collected automatically via cookies to optimize website functionality and user experience.
• Online Form Submissions: Any personal contact information submitted through online forms or scheduling links is encrypted and used solely to respond to your inquiries, schedule consultations, or coordinate your care. We do not sell or trade website visitor data to third-party marketers.