NOTICE OF PRIVACY PRACTICES

Effective Date: March 1, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Contact Information

Privacy Officer: Tom Carroll
Practice Name: ProCare Pelvic Health
Address: 5 Walter Foran Blvd Suite 4005 Flemington, NJ 08822
Phone: (267) 671-2419

Our Legal Duty

ProCare Pelvic Health is required by law to maintain the privacy and security of your Protected Health Information (PHI), to provide you with this Notice of our legal duties and privacy practices, and to follow the terms of this Notice currently in effect.

We are also required to notify you in the event of a breach of your unsecured PHI.

We reserve the right to change the terms of this Notice at any time. Any revised Notice will apply to all PHI we maintain and will be posted on our website and available upon request.

Your Health Information

This Notice applies to the medical and billing records we create and maintain about you. Your PHI may include information about:

Your medical history
Examination and test results
Diagnoses and treatment
Therapy services
Billing and payment information
Other health-related information created or received by ProCare Pelvic Health

PHI may be maintained in paper, electronic, or other formats.

How We May Use and Disclose Your Health Information

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your health care and related services. This may include communication with physicians or other healthcare providers involved in your care.

Payment

We may use and disclose your PHI to obtain payment for services provided to you, including billing your health plan or other third parties.

Health Care Operations

We may use and disclose your PHI for operational activities such as quality assessment, staff training, licensing, accreditation, and business management.

Appointment Reminders

We may contact you to remind you of appointments.

As Required by Law

We may use or disclose your PHI when required by federal, state, or local law, including for public health activities, health oversight activities, law enforcement purposes, judicial proceedings, workers' compensation, or to avert a serious threat to health or safety.

Individuals Involved in Your Care

We may disclose relevant PHI to family members, friends, or others involved in your care or payment for your care, unless you object.

We may also use or disclose information that has been de-identified so that it no longer identifies you.

Uses and Disclosures Requiring Your Written Authorization

We will obtain your written authorization before:

Selling your PHI
Using or disclosing your PHI for most marketing purposes where authorization is required by law
Any other uses not described in this Notice

You may revoke your authorization in writing at any time, except to the extent we have already relied upon it.

Your Rights Regarding Your Health Information

Right to Inspect and Obtain a Copy

You have the right to inspect and obtain a copy of your PHI maintained by us.

If we maintain your PHI electronically, you have the right to request an electronic copy in the form and format reasonably available.

We may charge a reasonable, cost-based fee as permitted by law.

Right to Request an Amendment

If you believe your PHI is incorrect or incomplete, you may request an amendment in writing.

Right to an Accounting of Disclosures

You may request a list of certain disclosures of your PHI made by us during the six years prior to your request, excluding disclosures for treatment, payment, and health care operations.

The first accounting in a 12-month period is free. We may charge a reasonable fee for additional requests.

Right to Request Restrictions

You have the right to request restrictions on certain uses or disclosures of your PHI.

We are not required to agree to most requested restrictions.

However, we are required to agree to a restriction request if:

The disclosure is to a health plan for purposes of payment or health care operations
The PHI relates solely to a health care item or service for which you (or someone on your behalf) have paid us out-of-pocket in full
The disclosure is not otherwise required by law

Right to Request Confidential Communications

You may request that we communicate with you about your health information in a specific way or at a specific location. We will accommodate reasonable requests.

Right to a Paper Copy

You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive it electronically.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with: