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: June 17, 2026
Moxie Wellness (“we,” “us,” or “our”) is required by law to maintain the privacy 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 the Notice currently in effect. PHI is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services.
This Notice applies to the telehealth services we provide to patients located in the jurisdictions we serve, currently Florida and the District of Columbia.
How we may use and disclose your health information
The following describes the ways we may use and disclose your PHI. Not every use or disclosure will be listed, but all permitted uses and disclosures fall within one of these categories.
For treatment. We use and disclose your PHI to provide, coordinate, and manage your health care. For example, we may use your PHI to evaluate your condition during a telehealth visit, prescribe medication, and coordinate with a pharmacy that fills your prescription or with another provider involved in your care.
For payment. We may use and disclose your PHI to obtain payment for the services we provide. For example, we may use your information to process your payment for a consultation. Because our practice is cash-pay, we generally do not bill insurance; if we ever do so at your request, we may share information necessary for that purpose.
For health care operations. We may use and disclose your PHI for operations necessary to run our practice and ensure quality care. For example, we may use your information for internal quality review, to respond to your questions, or to support business functions performed by our service providers.
To business associates. We may disclose your PHI to third parties that perform services on our behalf — such as scheduling, secure communication, payment processing, practice email, and technical hosting. These business associates are required by written agreement to protect your PHI and use it only for permitted purposes.
Appointment reminders and treatment communications. We may contact you to provide appointment reminders, follow up on your care, or share information about treatment options.
Uses and disclosures that may be made without your authorization or opportunity to object
We may use or disclose your PHI without your authorization in the following circumstances, to the extent permitted by law:
- As required by law, including federal, state, or local law.
- For public health activities, such as reporting disease, injury, or vital events to public health authorities.
- About victims of abuse, neglect, or domestic violence, to the extent required or permitted by law, including state-mandated child-abuse reporting.
- For health oversight activities authorized by law, such as audits, investigations, and licensure actions.
- For judicial and administrative proceedings, in response to a court order, subpoena, or other lawful process.
- For law enforcement purposes, as permitted or required by law.
- To coroners, medical examiners, and funeral directors, as authorized by law.
- For organ and tissue donation, where applicable.
- For research, when permitted by law and subject to applicable safeguards.
- To avert a serious threat to health or safety of you or the public.
- For specialized government functions, such as military, national security, or protective services.
- For workers’ compensation, as authorized by and to the extent necessary to comply with applicable law.
Uses and disclosures that require your written authorization
Other uses and disclosures of your PHI not described in this Notice will be made only with your written authorization. In particular, the following require your authorization:
- Most uses and disclosures of psychotherapy notes (where applicable);
- Uses and disclosures for marketing purposes; and
- Disclosures that constitute a sale of your PHI.
You may revoke an authorization in writing at any time, except to the extent we have already relied on it. We will honor your revocation as required by law.
Information with additional legal protections
Certain categories of health information are subject to special, more stringent protections under federal or state law. This may include, for example, substance use disorder treatment records protected under 42 C.F.R. Part 2, and information relating to mental health, HIV/AIDS, genetic information, or reproductive or sexual health. Where federal or state law provides protections more stringent than HIPAA for a category of information, we will follow the more protective law. We will not use or disclose such information in a manner inconsistent with those heightened protections.
Your rights regarding your health information
You have the following rights with respect to your PHI:
Right to request restrictions. You may request restrictions on how we use or disclose your PHI for treatment, payment, or health care operations. We are not required to agree to most requested restrictions. However, if you pay for a service or item out of pocket in full, you may request that we not disclose the PHI related to that service or item to a health plan for purposes of payment or operations, and we are required to honor that request unless the disclosure is otherwise required by law.
Right to confidential communications. You may request that we communicate with you about your health in a certain way or at a certain location (for example, by a specific phone number or email). We will accommodate reasonable requests.
Right to inspect and copy. You have the right to inspect and obtain a copy of your PHI maintained in a designated record set, including an electronic copy, subject to limited exceptions. We may charge a reasonable, cost-based fee as permitted by law.
Right to amend. You have the right to request an amendment to your PHI if you believe it is incorrect or incomplete. We may deny your request under certain circumstances and will provide a written explanation if we do.
Right to an accounting of disclosures. You have the right to request a list of certain disclosures we have made of your PHI, as required by law.
Right to a paper copy of this Notice. You have the right to obtain a paper copy of this Notice upon request, even if you have agreed to receive it electronically.
Right to be notified of a breach. You have the right to be notified following a breach of your unsecured PHI, as required by law.
To exercise any of these rights, contact us using the information at the end of this Notice. Certain requests must be made in writing.
Our duties
We are required by law to:
- maintain the privacy of your PHI;
- provide you with this Notice of our legal duties and privacy practices with respect to your PHI;
- abide by the terms of the Notice currently in effect; and
- notify you following a breach of your unsecured PHI.
We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have as well as any information we receive in the future. The current Notice will be posted on our website, and a copy will be available upon request. The effective date is noted at the top of this Notice.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below, and you may file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.
U.S. Department of Health and Human Services
Office for Civil Rights
Website: https://www.hhs.gov/hipaa/filing-a-complaint/index.html
Contact us
For questions about this Notice, to exercise your rights, or to file a complaint, contact:
Moxie Wellness
Attn: Privacy Officer
Email: support@moxie-wellness.com
Phone: 646-504-8944
Mailing address: 100 Church Street, New York, NY 10007