NOTICE OF PRIVACY PRACTICES
Effective Date: October 1, 2026
Elevated Health & Wellness, PLLC
6700 167th Street, Suite 3
Tinley Park, IL 60477
Phone: 312-927-1897
Email: info@myelevatedcare.com
Privacy Contact: Keyona Gayles, APRN-FPA, MSN, NP-C
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
YOUR RIGHTS
You have the right to:
• Obtain an electronic or paper copy of your medical record and other health information maintained by the practice
• Ask us to correct health information you believe is incorrect or incomplete
• Request that we contact you in a particular way or at a particular location
• Ask us to limit certain uses or disclosures of your information
• Request an accounting of certain disclosures of your health information
• Obtain a paper copy of this notice
• Designate a legally authorized personal representative
• File a complaint if you believe your privacy rights have been violated
We will respond to requests within the time required by applicable law. Reasonable, cost-based fees may apply to certain record requests when permitted.
YOUR CHOICES
In certain circumstances, you may tell us how you want your information shared, including communications with family members, friends, caregivers, or others involved in your care or payment for your care.
We will obtain your written authorization for uses or disclosures that require authorization, including most uses for marketing, the sale of protected health information, and most disclosures of psychotherapy notes when applicable. You may revoke an authorization in writing, except to the extent that we have already relied upon it.
HOW WE MAY USE AND DISCLOSE YOUR INFORMATION
Treatment. We may use and disclose your health information to provide, coordinate, and manage your care and to communicate with other healthcare professionals involved in your treatment.
Payment. We may use and disclose your information to bill for services, obtain payment, determine benefits, and communicate with health plans or other responsible payers.
Healthcare operations. We may use and disclose your information to operate the practice, improve services, conduct quality review, train staff, perform administrative functions, and contact you when necessary.
Public health and safety. We may disclose information for legally authorized public-health activities, product recalls, adverse-event reporting, reports of abuse or neglect, or to prevent or reduce a serious threat to health or safety.
Health oversight and legal requirements. We may disclose information to authorized oversight agencies or when federal or state law requires us to do so.
Law enforcement and legal proceedings. We may disclose information in response to qualifying court orders, subpoenas, administrative proceedings, or lawful requests from law-enforcement authorities, subject to applicable limitations.
Workers’ compensation. We may disclose information as permitted or required for workers’ compensation matters.
Research. We may use or disclose information for research when applicable legal requirements have been satisfied.
Decedents and donation. We may disclose information to coroners, medical examiners, funeral directors, and organ-procurement organizations when legally permitted.
Special government functions. We may make disclosures for legally authorized military, national-security, protective-service, or correctional purposes.
APPLICABLE ADDITIONAL PROTECTIONS
We will comply with federal and Illinois laws that provide additional protection for certain categories of health information. These may include mental-health, substance-use-disorder, HIV/AIDS, genetic, reproductive-health, and other specially protected records.
Where the law requires specific written authorization or imposes stricter disclosure limits, we will follow the stricter requirement.
OUR RESPONSIBILITIES
We are required by law to maintain the privacy and security of protected health information, provide this notice, and follow the privacy practices described in the current notice.
We will notify affected individuals as required if a breach occurs that may have compromised the privacy or security of protected health information.
We will not use or disclose your information except as described in this notice or as otherwise permitted or required by law. Uses and disclosures requiring authorization will be made only with your written permission.
COMPLAINTS
You may submit a privacy complaint to the practice using the contact information above. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights:
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue SW
Washington, DC 20201
Telephone: 1-877-696-6775
https://www.hhs.gov/hipaa/filing-a-complaint/
Elevated Health & Wellness will not retaliate against you for filing a complaint.
CHANGES TO THIS NOTICE
We may change the terms of this notice, and changes may apply to health information already maintained by the practice. The current notice will be available upon request, in the office, and on the practice website.