Your Information. Your Rights. Our Responsibilities.

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: 09/12/2026

Your Rights

You have the right to:

Get an electronic or paper copy of your medical record

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee as permitted by law.

Ask us to correct your medical record

You can ask us to correct health information about you that you believe is incorrect or incomplete. We may deny your request in certain circumstances, but we will explain the reason in writing, usually within 60 days.

Request confidential communications

You can ask us to contact you in a specific way, such as at a particular phone number or email address, or to send mail to a different address. We will accommodate reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are generally not required to agree to your request. If you pay for a service or health care item out of pocket in full, you can ask us not to share that information with your health plan for payment or health care operations, and we will comply unless the law requires us to share it.

Get a list of those with whom we’ve shared information

You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all disclosures except those for treatment, payment, and health care operations, and certain other disclosures as permitted by law. We will provide one accounting per year for free but may charge a reasonable, cost-based fee if you request another within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights and make choices about your health information. We will verify that the person has this authority before taking action.

File a complaint if you believe your privacy rights have been violated

You can complain to us if you believe we have violated your privacy rights by contacting Nora Wellness & Management using the contact information provided in this notice. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting the HHS Office for Civil Rights complaint website. We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, tell us what you want us to do. We will follow your instructions when possible.

Share information with family, close friends, or others involved in your care

You can tell us whether we may share relevant health information with family members, close friends, or others involved in your care or payment for your care. If you are unable to tell us your preference, for example if you are unconscious, we may share information if we believe it is in your best interest and permitted by law.

Disaster-relief situations

We may share information about you with an organization assisting in a disaster-relief effort when permitted by law. You may tell us your preferences regarding this type of disclosure.

Mental health information

We will not use or share certain health information for purposes not described in this notice without your written authorization when authorization is required by law. Certain mental health information, including psychotherapy notes, may receive additional protections under federal or state law.

Marketing and sale of your information

We will not use or share your health information for marketing purposes or sell your health information without your written authorization when authorization is required by law.

Our Uses and Disclosures

We typically use or share your health information in the following ways:

Treat you

Your health information may be used or shared with other health care professionals who are treating you or involved in your care.

Run our organization

We may use and share your health information to operate our practice, improve the quality of care we provide, coordinate services, and manage our health care operations.

Bill for your services

We may use and share your health information to bill and obtain payment from health plans or other entities responsible for payment for your care.

How else can we use or share your health information?

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good, such as public health and research. We must meet legal requirements before we share your information for these purposes.

Help with public health and safety issues

We may share health information about you for certain situations, such as preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect, or domestic violence, or preventing or reducing a serious threat to anyone’s health or safety.

Do research

We may use or share your information for health research when permitted by law and when applicable legal requirements are met.

Respond to organ and tissue donation requests

We may share health information about you with organ procurement organizations when permitted by law.

Work with a medical examiner or funeral director

We may share health information with a coroner, medical examiner, or funeral director when an individual dies and when permitted by law.

Comply with the law

We will share information about you when state or federal law requires it, including with the U.S. Department of Health and Human Services if it wants to confirm that we are complying with federal privacy law.

Address workers’ compensation, law enforcement, and other government requests

We may use or share health information about you for workers’ compensation claims, certain law-enforcement purposes, health oversight activities authorized by law, and certain special government functions.

Respond to lawsuits and legal actions

We may share health information about you in response to a court or administrative order, or in response to a subpoena or other lawful process when the applicable legal requirements are satisfied.

Special protection for substance use disorder records: If we maintain substance use disorder patient records protected by 42 CFR Part 2, we will not use or disclose those records in civil, criminal, administrative, or legislative investigations or proceedings against you without your consent or a court order and subpoena as required by law.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.

We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

We must follow the duties and privacy practices described in this notice and provide you with a copy of it.

We will not use or share your information other than as described in this notice unless you tell us in writing that we may. If you give us written permission, you may change your mind at any time by notifying us in writing.

Changes to the Terms of This Notice

We may change the terms of this notice, and the changes will apply to all health information we maintain about you. The revised notice will be available upon request, in our office, and on our website.

Contact Information

Nora Wellness & Management, PLLC

Phone: (425) 835-3352
Fax: (904) 920-8541
Email: Noramanagement.Wellness@gmail.com
Website: nora-wellness.com
Mailing Address: 100 N Howard ST STE R, Spokane, WA 99201-0508