Notice of Privacy Practices

Effective Date: July 24, 2025

ACE MEDICAL LLC
6428 Beach Blvd., Jacksonville, FL 32216
Phone: (904) 475-2039
Privacy Officer: Beverly Pateman

Your Rights, Our Responsibilities

This notice describes how your medical information may be used and disclosed and how you can access this information. Please review it carefully.

Your Rights

• Access your medical records in paper or electronic form
• Request corrections to inaccurate or incomplete information
• Request confidential communications (e.g., via a specific phone or address)
• Limit information we share for treatment, payment, or operations
• Get a list of those with whom we’ve shared your PHI
• Receive a paper copy of this notice, even if you agreed to receive it electronically
• Choose someone to act for you (e.g., medical power of attorney)
• File a complaint without fear of retaliation

Our Uses and Disclosures

We typically use or share your health information to:

• Treat you by communicating with other healthcare providers
• Run our organization and improve your care
• Bill for services and receive payment from insurers
• Contact you about appointments, services, or follow-up care

Other uses and disclosures may include:

• Public health and safety: prevent disease, report reactions, or report abuse/neglect
• Health oversight activities: audits, investigations, or inspections by agencies
• Legal and government requests: responding to court orders or law enforcement
• Organ and tissue donation
• Medical examiners and funeral directors
• Workers’ compensation claims
• Research (with approval and safeguards in place)

Your Choices

You may choose to tell us whether we can:

• Share information with your family, friends, or others involved in your care
• Include you in our facility directory
• Contact you for fundraising purposes (you can opt out)

We will never share your information without written authorization for:

• Marketing purposes
• Sale of your information
• Psychotherapy notes

When Consent Is Not Required

• Treatment coordination
• Public health emergencies
• Legal requirements
• National security or military service
• Law enforcement (e.g., responding to a warrant)
• Serious threats to health or safety

Our Legal Responsibilities

• Protect the privacy and security of your protected health information (PHI)
• Notify you promptly if a breach occurs that may compromise your information
• Provide this notice and follow the practices it describes
• Not use or disclose your PHI other than as described without your written consent

Filing a Complaint

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

Ace Medical Privacy Officer
6428 Beach Blvd., Jacksonville, FL 32216
Phone: (904) 475-2039

Or with the U.S. Department of Health and Human Services:

Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
https://www.hhs.gov/ocr/privacy/hipaa/complaints

We will not retaliate against you for filing a complaint.

Changes to This Notice

We may change the terms of this notice at any time. Changes will apply to all PHI we maintain. A current copy will always be available at our office and on our website.