HIPAA Notice of Privacy Practices

Our Legal Duty

We are required by law to maintain the privacy of your protected health information (PHI), to provide you with notice of our legal duties and privacy practices with respect to PHI, and to notify you following a breach of unsecured PHI.

We are required to abide by the terms of this Notice while it is in effect. We reserve the right to change the terms of this Notice and to make the new Notice effective for all PHI that we maintain. Upon request, we will provide you with any revised Notice of Privacy Practices.

How We May Use and Disclose Your PHI

The following describes the ways we may use and disclose your PHI. Not every use or disclosure in a category will be listed; however, all of the ways we are permitted to use and disclose information will fall within one of these categories.

• Treatment — We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services. For example, we may share your information with our compounding pharmacy to fulfill a prescription.
• Payment — We may use and disclose your PHI to obtain payment for services rendered. For example, we may share information necessary to process a claim or to verify insurance eligibility.
• Healthcare Operations — We may use and disclose your PHI for our business operations, including quality assessment, training, compliance, and other administrative functions.
• As Required by Law — We will disclose your PHI when required to do so by applicable federal or state law.
• Public Health Activities — We may disclose your PHI to public health authorities as authorized or required by law.
• Serious Threats to Health or Safety — We may disclose your PHI when necessary to prevent a serious and imminent threat to your health or safety, or the health or safety of the public.

Your Rights Regarding Your PHI

You have the following rights regarding your PHI:

• Right to Inspect and Copy — You have the right to inspect and copy your PHI that we maintain. We may charge a reasonable fee for copying.
• Right to Amend — You have the right to request that we amend PHI that you believe is incorrect or incomplete. We may deny the request under certain circumstances.
• Right to an Accounting of Disclosures — You have the right to request a list of certain disclosures we have made of your PHI.
• Right to Request Restrictions — You have the right to request restrictions on how we use or disclose your PHI. We are not required to agree to all requested restrictions.
• Right to Request Confidential Communications — You have the right to request that we communicate with you in a specific way or at a specific location.
• Right to a Paper Copy — You have the right to obtain a paper copy of this Notice upon request.

Uses and Disclosures Requiring Your Authorization

Other uses and disclosures of PHI not covered by this Notice will be made only with your written authorization. If you provide us with written authorization, you may revoke it at any time in writing, except to the extent that we have already taken action in reliance on such authorization.

How to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights. To file a complaint with us, contact:

Bloom by Roze Health, LLC — Privacy Officer
Email: care@bloombyrozehealth.com

You will not be retaliated against for filing a complaint.

Effective Date and Updates

This Notice is effective January 1, 2026. We reserve the right to change this Notice at any time. We will post revised Notices on our website at www.bloombyrozehealth.com.