HIPAA Notice of Privacy Practices

Effective Date: June 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Commitment to Your Privacy

Dvora Healthcare understands the importance of protecting your medical information. We are committed to maintaining the privacy and security of your Protected Health Information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

Protected Health Information includes information about your health condition, treatment, healthcare services, and payment for healthcare services that can identify you.

How We May Use and Disclose Your Information

For Treatment

We may use and share your medical information to provide, coordinate, and manage your healthcare services.

Examples include:

• Communicating with physicians, specialists, hospitals, pharmacies, and other healthcare providers involved in your care
• Coordinating treatment plans
• Reviewing medications and medical history

For Payment

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

Examples include:

• Billing insurance companies
• Verifying insurance coverage
• Processing claims and payment requests

For Healthcare Operations

We may use and disclose information to support the operation of our healthcare practice.

Examples include:

• Quality improvement activities
• Clinical reviews
• Staff training
• Compliance and auditing activities

As Required by Law

We may disclose information when required by federal, state, or local law.

Examples include:

• Public health reporting
• Court orders
• Law enforcement requests
• Government oversight activities

Other Uses and Disclosures

Certain uses and disclosures require your written authorization. You may revoke an authorization at any time, except to the extent action has already been taken.

Your Rights Regarding Your Health Information

You have the right to:

Access Your Records

Request to inspect or obtain copies of your medical records, subject to certain limitations permitted by law.

Request Corrections

Request amendments to information you believe is incorrect or incomplete.

Request Restrictions

Request limitations on certain uses or disclosures of your information.

Request Confidential Communications

Ask us to communicate with you through alternative methods or at alternative locations.

Receive an Accounting of Disclosures

Request a list of certain disclosures we have made of your health information.

Receive a Copy of This Notice

You may request a paper copy of this Notice at any time.

Our Responsibilities

Dvora Healthcare is required by law to:

• Maintain the privacy and security of your Protected Health Information
• Provide you with this Notice of Privacy Practices
• Follow the terms of this Notice currently in effect
• Notify you if a breach occurs that may have compromised your information

Changes to This Notice

We reserve the right to modify this Notice and make revised terms effective for all Protected Health Information we maintain. Updated versions will be available upon request and on our website.

Questions or Complaints

If you believe your privacy rights have been violated, you may contact Dvora Healthcare without fear of retaliation.

Contact Information

Dvora Healthcare

Serving Salt Lake County, Utah

Phone: (801) 407-9409

Email: Intake@dvorahealthcare.com

Website: www.dvorahealthcare.com

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