HIPAA Notice of Privacy Practices

NOTICE OF PRIVACY PRACTICES. 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: October 19, 2026
Practice: Refresh MedSpa (REFRESH MEDSPA, LLC), 407 Cape Coral Parkway W, STE B, Cape Coral, FL 33914
Privacy contact: Vanessa Levine, APRN, NP-C, Founder, (239) 321-5050, info@refreshmedspafl.com

Who this notice covers. This notice applies to Refresh MedSpa, its providers and staff.

Our commitment to your privacy. We understand that your medical information is personal, and we are dedicated to safeguarding it. We create and keep records of the care and services you receive with us, which we need to give you quality care and to meet legal requirements. This notice applies to all of those records. Please do not send medical details through the website forms or chat; call us instead.

We are required by law to

• Keep the privacy of your protected health information (PHI).
• Give you this notice of our legal duties and privacy practices.
• Follow the terms of the notice currently in effect.
• Tell you if a breach of your unsecured PHI occurs, as the law requires.

“Protected health information” means information that identifies you and relates to your past, present or future physical or mental health, the care you receive, or payment for it.

How we may use and disclose your medical information

Treatment: to provide, coordinate or manage your care, including sharing information with other healthcare providers involved in your care.

Payment: to bill for services and collect payment from you, an insurer or another third party, including sharing information with your health plan to obtain payment or approval.

Healthcare operations: to run the practice, such as quality review, provider training and evaluation, accreditation, and business planning.

Business associates: companies that provide services to us, such as scheduling, communication and record-keeping systems, may receive information to do that work. We require them by contract to protect it.

Appointment reminders and aftercare: to remind you of appointments, follow up on your treatment, recommend aftercare and tell you about related services we offer.

Family and friends: to share relevant information with a family member or friend involved in your care, unless you object. In an emergency, or if you cannot object, we may share it if we believe it is in your best interest.

As required or permitted by law: when federal, state or local law requires it; for public health activities, such as preventing disease, reporting abuse or neglect, and reporting reactions to medications or products; to health oversight agencies for audits, investigations, inspections and licensing; in response to a court order or other lawful process in a lawsuit or dispute; to law enforcement in limited circumstances; to correctional institutions if you are an inmate; to medical examiners; and to authorized federal officials for national security and intelligence activities.

Uses that need your written permission

We will not use or share your information for marketing, sell it, or share psychotherapy notes without your written authorization. Any other use not described in this notice also needs your written authorization. You may revoke an authorization in writing at any time; this stops future uses but does not undo what was already done with your permission.

Your rights

To use any of these rights, write to us at info@refreshmedspafl.com or at the address above.

• See and get a copy of your medical records, on paper or electronically. We may charge a reasonable, cost-based fee.
• Ask us to correct information you believe is wrong or incomplete, saying why. We may say no in some cases, and if we do, we will tell you why in writing.
• Ask for a list of certain disclosures we have made, for a period you choose (up to six years). The first list in a year is free; we may charge for more.
• Ask for confidential communication, for example at a different phone number or address. We will agree to reasonable requests.
• Ask us to limit what we use or share for treatment, payment or operations. We are not required to agree in most cases. If you pay for a service in full out of pocket, you may ask us not to disclose information about that service to your health plan for payment or health care operations. We will honor that restriction unless disclosure is required by law.
• Choose someone to act for you, such as a legal guardian or someone with your medical power of attorney.
• Get a paper copy of this notice at any time, even if you received it electronically.

Changes to this notice

We may change this notice, and the change will apply to information we already have as well as future information. The current notice is available at our clinic and on our website at refreshmedspafl.com/hipaa-privacy-statement/.

Complaints

You may submit a privacy complaint to Refresh MedSpa at info@refreshmedspafl.com or at the mailing address above. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights online through the HHS complaint portal. We will not retaliate against you for filing a complaint.