HIPAA Notice of Privacy Practices

Last Updated: December 1, 2025

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.

Madison Avenue Face & Body (“we,” “our,” or “the Practice”) is committed to protecting your medical information and complying with all applicable federal and state privacy laws, including the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).

1. Your Rights Regarding Your Health Information

You have the following rights concerning your Protected Health Information (“PHI”):

Right to Access

You may request to view or obtain a copy of your medical records and other health information we maintain.

Right to Request Corrections

If you believe your information is incomplete or incorrect, you may request a correction.

Right to Request Confidential Communications

You may request that we contact you in a specific way (e.g., at a work phone or a mailing address different from your home).

Right to Request Restrictions

You may ask us not to use or share certain health information for treatment, payment, or operations. While we are not required to agree to all requests, we will accommodate reasonable restrictions when possible.

Right to an Accounting of Disclosures

You may request a list of certain disclosures of your health information made by the Practice in the previous six years, excluding those made for treatment, payment, or healthcare operations.

Right to a Paper or Digital Copy of This Notice

You may request a paper copy of this Notice at any time, even if you have received it electronically.

Right to Choose a Personal Representative

If someone is legally authorized to act on your behalf (e.g., healthcare proxy, guardian), we will treat that person as your representative.

Right to File a Complaint

You may file a complaint with us or with the U.S. Department of Health & Human Services if you believe your privacy rights have been violated. We will not retaliate against you for filing a complaint.

2. How We Use and Disclose Health Information

We may use and share your health information in the following ways:

For Treatment

We may use or disclose your PHI to provide, coordinate, or manage your medical care and services. This includes communication with referring providers, specialists, and other members of your care team.

For Payment

We may use or disclose your information to bill and collect payment for services provided, including communications with insurance companies (if applicable).

For Healthcare Operations

We may use or disclose PHI to support practice operations such as quality improvement, accreditation, training, audits, and compliance activities.

To Contact You

We may use your information to send appointment reminders, scheduling confirmations, follow-up communications, or other administrative notifications.

3. Other Uses and Disclosures Allowed Without Authorization

We may share your information without your written authorization in the following situations:

  • As required by law

  • For public health and safety matters

  • For reporting abuse, neglect, or domestic violence

  • For health oversight activities (audits, investigations)

  • For legal proceedings and law enforcement requests

  • To avert a serious threat to health or safety

  • For workers’ compensation claims

  • With coroners, medical examiners, or funeral directors

  • For research purposes when approved by an Institutional Review Board (IRB)

In all such cases, disclosures are limited to the minimum necessary.

4. Uses and Disclosures Requiring Your Written Authorization

We will not use or share your information for the following without your written consent:

  • Marketing communications

  • Sale of your PHI

  • Most uses or disclosures of psychotherapy notes (if applicable)

  • Digital media use such as photos, videos, or testimonials

  • Any disclosure not described in this Notice

You may revoke an authorization at any time in writing, except for actions already taken in reliance on the authorization.

5. Our Responsibilities

We are required by law to:

  • Maintain the privacy and security of your PHI

  • Provide you with this Notice describing our legal duties and privacy practices

  • Notify you if a breach occurs that may have compromised the privacy of your information

  • Follow the terms of this Notice while it is in effect

We reserve the right to change our privacy practices and update this Notice. Any revised Notice will be posted on our website and available upon request.

6. Confidentiality & Data Security

To protect your health information, we implement:

  • HIPAA-compliant electronic medical record systems

  • Encryption and secure transmission protocols

  • Access controls and authentication

  • Staff training in privacy and security

  • Policies for handling, storing, and disposing of PHI

While we follow industry best practices, no system is completely risk-free.

7. Filing a Complaint

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

With Madison Avenue Face & Body:

Email: info@madisonavenuefaceandbody.com
Phone: 212 684-0315
Address: New York, NY

With the U.S. Department of Health & Human Services:

Office for Civil Rights (OCR)
U.S. Department of Health & Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Website: https://www.hhs.gov/ocr

You will not be penalized or retaliated against for filing a complaint.

8. Contact Us

If you have questions about this Notice or your privacy rights, please contact us:

Madison Avenue Face & Body
New York, NY
Email: info@madisonavenuefaceandbody.com
Phone: 212 684-0315