NOTICE OF PRIVACY PRACTICES

Healique Health LLC
Effective Date: October 2026
Updated: October 2026
 

Your Information. Your Rights. Our Responsibilities.
 

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, HOW YOU CAN GET ACCESS TO THIS INFORMATION, AND YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION. PLEASE REVIEW IT CAREFULLY.
 

This Notice of Privacy Practices applies to healthcare services provided by Healique Health, LLC ("Healique Health," "we," "our," or "us").
 

Healique Health is committed to protecting the privacy and security of your health information. We are required by law to maintain the privacy and security of protected health information ("PHI"), provide you with this Notice, and follow the privacy practices described in the Notice currently in effect.
 

YOUR RIGHTS

When it comes to your health information, you have certain rights.
 

Get a Copy of Your Health Information

You may ask to inspect or receive an electronic or paper copy of your medical record and other health information we maintain about you.

We will generally provide a copy or summary within the timeframe required by law. A reasonable, cost-based fee may apply when permitted.
 

Ask Us to Correct Your Medical Record

If you believe information in your medical record is incorrect or incomplete, you may ask us to amend it.

We may deny certain requests as permitted by law, but if we do, we will provide an explanation in writing.
 

Request Confidential Communications

You may ask us to contact you in a specific way—for example, at a particular telephone number—or to send correspondence to a different address.

We will accommodate reasonable requests as required by law.
 

Ask Us to Limit What We Use or Share

You may ask us not to use or disclose certain health information for treatment, payment, or healthcare operations.

We are not required to agree to every request.
 

However, if you pay for a healthcare service or item in full out-of-pocket, you may ask us not to disclose information about that service to your health plan for payment or healthcare operations. We will honor that request unless disclosure is required by law.
 

Get a List of Certain Disclosures

You may request an accounting of disclosures, which is a list of certain instances in which we disclosed your health information.

Generally, you may request an accounting covering the six years before the date of your request. Certain disclosures, including many disclosures for treatment, payment, and healthcare operations, are not included.
 

Get a Copy of This Notice

You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.
 

Choose Someone to Act for You

If you have given someone medical power of attorney or another person has legal authority to act as your personal representative, that person may exercise applicable privacy rights on your behalf.

We may verify that person's authority before taking action.
 

File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with Healique Health using the contact information at the end of this Notice.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights (OCR).

Healique Health will not retaliate against you for filing a privacy complaint.
 

U.S. Department of Health and Human Services — File a HIPAA Complaint
 

YOUR CHOICES

For certain health information, you may tell us your preferences about what we share.

For example, when permitted by law, you may tell us whether we may:

• Share relevant information with family members, friends, or others involved in your care;

• Share information in a disaster-relief situation; or

• Communicate with someone responsible for payment for your care.
   

If you are unable to tell us your preference—for example, because you are unconscious—we may disclose information when we reasonably believe doing so is in your best interest and the law permits it.
 

Marketing and Sale of Information

For certain purposes, including many marketing activities and the sale of PHI, we will obtain your written authorization when required by law.

Healique Health does not sell your protected health information for commercial purposes.

If you authorize us to use or disclose your health information, you may generally revoke that authorization in writing at any time, subject to applicable limitations.
 

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

HIPAA allows us to use and disclose your health information for certain purposes without obtaining separate authorization from you.

Treatment

We may use and share your health information to provide, coordinate, or manage your healthcare.

For example, we may share relevant information with another healthcare professional, laboratory, pharmacy, specialist, or facility involved in your treatment.

Payment

We may use and disclose your information to obtain payment for healthcare services.

For example, when applicable, information may be provided to a health plan to determine eligibility, obtain authorization, process a claim, or receive payment.

Healthcare Operations

We may use and disclose your health information to operate our practice and improve the quality of services we provide.

This may include activities such as:

• Quality assessment and improvement;

• Staff and provider review;

• Compliance activities;

• Business planning;

• Auditing;

• Credentialing; and

• Practice administration.

These treatment, payment, and healthcare-operation uses are among the routine uses recognized in the current HHS provider model NPP.
 

OTHER PERMITTED OR REQUIRED USES AND DISCLOSURES

We may also use or disclose your health information when permitted or required by law, including for certain:
 

Public health and safety activities. This may include reporting certain diseases, adverse events, or suspected abuse or neglect when required or authorized by law.
 

Health oversight activities. We may disclose information to authorized agencies for audits, investigations, inspections, licensing, and other legally authorized oversight activities.
 

Legal proceedings. Information may be disclosed in response to certain court or administrative orders, subpoenas, discovery requests, or other lawful processes, subject to applicable requirements.
 

Law-enforcement purposes. Information may be disclosed to law enforcement when specifically permitted or required by law.
 

Workers' compensation. Information may be disclosed as authorized by workers' compensation or similar laws.
 

Prevention of serious threats. We may use or disclose health information when permitted by law to prevent or reduce a serious and imminent threat to health or safety.
 

Medical examiners, coroners, and funeral directors. Information may be disclosed when authorized by law.
 

Government functions. Certain disclosures may be permitted for military, national security, protective services, correctional, or other governmental purposes.
 

TELEHEALTH AND ELECTRONIC COMMUNICATIONS

Because Healique Health provides virtual healthcare services, some PHI may be created, transmitted, or maintained electronically. We take reasonable and appropriate safeguards to protect information used during telehealth encounters and electronic communications. Patients should participate in telehealth appointments from a private location whenever possible and use Healique Health's designated secure patient portal for sensitive healthcare communications when instructed. Electronic communications may include appointment reminders, scheduling information, portal notifications, billing communications, and other permitted healthcare communications.
 

MEDICAL CANNABIS INFORMATION

Healique Health may collect, maintain, and disclose health information necessary to evaluate patients for medical cannabis certification and to comply with applicable Maryland requirements.

Information related to a medical cannabis evaluation remains part of the patient's health record and will be handled in accordance with applicable privacy requirements. Where disclosure is required to complete an authorized certification, registration, reporting, or regulatory function, relevant information may be provided to the appropriate governmental system or agency as permitted or required by law.
 

EMOTIONAL SUPPORT ANIMAL EVALUATIONS

Information collected during an Emotional Support Animal evaluation is considered part of your health record when created or maintained by Healique Health in connection with your care.

Healique Health will not ordinarily provide your clinical information to a landlord, housing provider, employer, educational institution, or other third party without your authorization unless disclosure is otherwise permitted or required by law. If you request that we complete or provide documentation to another party, we may require appropriate written authorization before releasing information.
 

WEIGHT MANAGEMENT

Information related to your medical weight-management care—including health history, weight-related information, laboratory results, medications, treatment plans, and progress—is maintained as part of your medical record and protected in accordance with applicable privacy requirements. Relevant information may be shared with pharmacies, laboratories, other treating healthcare professionals, health plans, or other entities as permitted or required for treatment, payment, or healthcare operations.
 

MOBILE AND IN-PERSON SERVICES

Healique Health may provide physical examinations and other eligible services at mobile, community, school, employer, or other approved locations. We will take reasonable steps to protect the privacy of your health information when services are provided outside a traditional medical office. Your medical information will not be disclosed to a school, employer, athletic organization, or other third party merely because the examination occurs at its location. Information will be disclosed only as authorized by you or otherwise permitted or required by law.
 

SUBSTANCE USE DISORDER RECORDS

Certain substance use disorder records may receive additional confidentiality protections under federal law, including 42 CFR Part 2, when applicable. If Healique Health creates, receives, or maintains records subject to these requirements, such information will be used and disclosed only as permitted by applicable federal and state law. Where patient consent is required for a use or disclosure of Part 2 records, Healique Health will obtain the required consent.

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OUR RESPONSIBILITIES

Healique Health is required to:

• Maintain the privacy and security of your protected health information;

• Follow the duties and privacy practices described in the Notice currently in effect;

• Provide you with a copy of this Notice;

• Notify you as required if a breach occurs that may have compromised the privacy or security of your information; and

• Refrain from using or disclosing your health information except as described in this Notice or otherwise permitted or required by law.

If you provide written authorization for a use or disclosure, you may generally revoke that authorization in writing at any time.
 

CHANGES TO THIS NOTICE

Healique Health reserves the right to change the terms of this Notice and its privacy practices as permitted by law.

Changes may apply to health information we already maintain as well as information received or created in the future.

When material changes are made, an updated Notice will be made available as required by law and posted on the Healique Health website.
 

QUESTIONS OR COMPLAINTS

If you have questions about this Notice, want to exercise your privacy rights, or believe your privacy rights have been violated, contact:

Healique Health, LLC
Privacy Officer: Tamara Gant MSN, CRNP, FNP-BC 
Email: healiquehealth@gmail.com
Phone: )301) 747-1218
 

You may also submit a complaint to the U.S. Department of Health and Human Services, Office for Civil Rights. Healique Health will not retaliate against you for filing a complaint.