Notice of Privacy Practices

Effective Date: [DATE]

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Our commitment

Blue Coral Women’s Care Inc is required by law to protect the privacy of your health information, to give you this Notice describing our legal duties and privacy practices, and to follow the terms of the Notice currently in effect.

“Protected health information” (PHI) means information that identifies you and relates to your physical or mental health, the health care you receive, or payment for that care.

How we may use and disclose your health information without your authorization

For treatment

To provide, coordinate, and manage your care. For example, sharing your results with a physician we consult, or sending records to a hospital if you need emergency care.

For payment

To bill and collect payment from you, your insurer, or another payer — including verifying coverage and obtaining prior authorization.

For health care operations

Quality assessment, staff training and evaluation, licensing, accreditation, business planning, and internal audits.

When required or permitted by law

This includes, but is not limited to:

• Reports to the Florida Agency for Health Care Administration (AHCA). Florida law requires clinics to submit monthly statistical reports about certain procedures. These reports do not include information that identifies you and are confidential and exempt from Florida’s public records law. We also report certain incidents to AHCA as required by rule.
• Communicable disease reporting. Florida law requires us to report certain sexually transmitted infections and other communicable diseases to the Florida Department of Health.
• Suspected abuse or neglect. We are required to report suspected abuse, neglect, or exploitation of a child to the Florida central abuse hotline, and of a vulnerable adult to the appropriate authority.
• Suspected human trafficking. Florida law requires reporting of known or suspected human trafficking — to local law enforcement if the patient is 18 or older, or to the central abuse hotline if the patient is a minor.
• Parents and legal guardians of patients under 18. For certain services, Florida law requires that we notify a parent or legal guardian and obtain their written, notarized consent before care is provided. See “If you are under 18” below.
• Health oversight. To agencies that license, audit, inspect, or investigate us, including AHCA surveyors and the Florida Department of Health.
• Judicial and administrative proceedings. In response to a court order, subpoena, or other lawful process, and only to the extent the law requires or permits.
• Law enforcement. In limited circumstances defined by law. See “Our position on law enforcement requests” below.
• Serious threat to health or safety. To prevent a serious and imminent threat to you or to others.
• Public health activities, coroners and medical examiners, organ donation, workers’ compensation, military and national security, as permitted by law.
• Research, only where an Institutional Review Board or privacy board has approved a waiver, or where the information has been de-identified.

Appointment reminders and health information

We may contact you to remind you of an appointment or to tell you about treatment alternatives or health-related benefits. You may ask us to limit or stop this contact at any time.

Uses and disclosures that always require your written authorization

We will not do any of the following without your signed authorization:

• Use or disclose psychotherapy notes, except in narrow circumstances the law specifies
• Use or disclose your PHI for marketing
• Sell your PHI

Any other use or disclosure not described in this Notice requires your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

Our position on law enforcement requests

HIPAA permits but does not require health care providers to disclose health information for certain law enforcement purposes. We want to be direct about how we handle this.

A note on the 2024 federal reproductive health privacy rule. In 2024, HHS issued a rule creating additional protections for reproductive health care information. On June 18, 2025, a federal court vacated most of that rule nationwide (Purl v. U.S. Dep’t of Health & Human Services, N.D. Tex.). Those additional federal protections are no longer in effect. The general HIPAA Privacy Rule continues to apply, along with Florida law.

If you are under 18

Florida law treats some care for minors differently, and we will not mislead you about this.

For termination of pregnancy, Florida law requires both:

• Notification of a parent or legal guardian by the physician, and
• Their written, notarized consent, with a copy of their government-issued identification.

There is a judicial waiver process available through the courts in certain circumstances. If you are a minor, call us and we will explain how it works, without judgment.

For some other services — including certain sexually transmitted infection testing and treatment, and certain contraceptive services — Florida law allows minors to consent for themselves. Ask us and we will tell you exactly what applies to the care you are seeking, before you share information with us.

Your rights

• Get a copy of your record. You may inspect and obtain a copy of your medical and billing records. We will respond within the time the law allows and may charge a reasonable, cost-based fee. You may ask for an electronic copy.
• Ask us to correct your record. If you believe information in your record is incorrect or incomplete, you may request an amendment in writing. We may deny the request in certain circumstances, and we will explain why in writing.
• Ask us to limit what we use or share. You may request a restriction on uses and disclosures. We are not generally required to agree — with one important exception, described immediately below.

• Ask us to contact you confidentially. You may ask us to reach you at a specific phone number, address, or by a specific method — for example, to call your mobile rather than a home phone, or to send nothing by mail. We will accommodate reasonable requests and will not ask you why.
• Get a list of disclosures. You may request an accounting of certain disclosures we made in the six years before your request. Disclosures for treatment, payment, and operations, and those you authorized, are not included.
• Get a paper copy of this Notice. You may request one at any time, even if you agreed to receive it electronically.
• Be notified of a breach. We will notify you if a breach compromises the privacy or security of your information, as required by federal and Florida law.
• Choose someone to act for you. A person with legal authority — a health care surrogate or guardian — may exercise these rights on your behalf. We will verify their authority.

To exercise any of these rights, contact our Privacy Officer at the number below.

Our responsibilities

• We are required by law to maintain the privacy and security of your PHI.
• We will notify you promptly if a breach occurs that may have compromised it.
• We must follow the duties and privacy practices described in this Notice and give you a copy.
• We will not use or share your information other than as described here unless you tell us in writing that we may. If you tell us we may and then change your mind, you may revoke that permission in writing at any time.

Changes to this Notice

We may change this Notice at any time, and any change will apply to information we already hold as well as information we create in the future. The current Notice will always be posted in our office and at [WEBSITE URL]/notice-of-privacy-practices, with its effective date. You may request a copy at any visit.

Complaints

If you believe your privacy rights have been violated, you may complain to us:

You may also complain to the federal government:

You may also contact the Florida Agency for Health Care Administration regarding the care you received: [AHCA COMPLAINT LINE / URL]

We will not retaliate against you for filing a complaint. Filing a complaint will not affect your care.

End of Notice of Privacy Practices.