IAMACOMEBACK, LLC

NOTICE OF PRIVACY PRACTICES

(Effective November 19, 2020)

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.

We understand that health information about you and your care is personal, and we are committed to protecting the information we receive about you. This notice explains how we may use and disclose protected health information about you. "Protected health information" means any health information that identifies you or can reasonably be used to identify you. In this notice, we refer to all protected health information as "medical information."

This notice also informs you about your rights and our responsibilities regarding your medical information. Additionally, it explains how you can raise concerns if you believe your privacy rights have been violated.

How We May Use and Disclose Medical Information About You

We use and disclose medical information about you for various purposes, which are outlined below.

For Treatment

We may use your medical information to provide, coordinate, or manage your care and related services. This may involve sharing information with doctors, nurses, hospitals, and other healthcare providers involved in your care. For example, we may consult with other healthcare providers regarding your treatment and share your medical information as part of that consultation. If you need specialized services, we may refer you to another provider and share your information with them to ensure you receive appropriate care.

For Operations

We may use and disclose your medical information for our operations, which are necessary for us to function effectively and provide quality care. This includes reviewing the services we provide and the performance of our employees. We may also use your information for training our staff, contractors, and agents. Additionally, we may use your information to explore ways to manage our organization more efficiently.

How We Will Contact You

Unless you instruct us otherwise in writing, we may contact you by telephone or mail at your home or workplace. We may leave messages for you on your answering machine or voicemail at either location. If you prefer us to communicate with you in a specific way or at a certain location, please see the section "Right to Receive Confidential Communications" for more information.

Service Alternatives

We may use and disclose your medical information to inform you about service alternatives that may be of interest to you.

Health-Related Benefits and Services

We may use and disclose your medical information to inform you about health-related benefits and services that may be of interest to you.

Marketing Communications

We may use and disclose your medical information to communicate with you about services. This may include describing a service provided by us, informing you about a service you have received, or recommending alternative treatments, therapies, healthcare providers, or care settings. We may also communicate with you about products and services during a face-to-face interaction or through a promotional gift of nominal value. Any marketing involving your medical information will only be done with your written authorization.

Individuals Involved in Your Services

We may disclose medical information about you to a family member, relative, close personal friend, or any other person you identify, as long as the information is directly relevant to their involvement in your care. We will provide an opportunity for you to agree or object to this disclosure, or we will infer from the circumstances that you do not object. We may also use or disclose medical information to notify or assist in notifying your family, relatives, or close friends about your location, general condition, or death. If there are specific individuals you do not want us to share your medical information with, please notify IAMACOMEBACK, LLC, or inform the staff member providing your care.

Required by Law

We may use or disclose your medical information when required by law, as long as the disclosure complies with the legal requirements.

Public Health Activities

We may disclose your medical information for public health activities, such as reporting to public health authorities for disease prevention or control, reporting child abuse or neglect, or reporting activities related to the safety or effectiveness of FDA-regulated products. These examples are not exhaustive but illustrate some of the situations where we may disclose your information.

Victims of Abuse, Neglect, or Domestic Violence

If we believe you are a victim of abuse, neglect, or domestic violence, we may disclose your medical information to a government authority authorized by law to receive such reports. This will be done as required by law and when we believe the disclosure is necessary to prevent serious harm to you or others.

Health Oversight Activities

We may disclose your medical information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, licensure, or disciplinary actions. These activities are necessary for the appropriate oversight of the healthcare system, government benefit programs, and compliance with various regulations.

Judicial and Administrative Proceedings

We may disclose your medical information in the course of any judicial or administrative proceeding if required by a court order or similar legal process. We will only disclose the information expressly authorized by the court order.

Disclosures for Law Enforcement Purposes

Under certain circumstances, we may disclose your medical information to law enforcement officials for law enforcement purposes, such as responding to a court order, subpoena, or warrant, or reporting certain types of injuries or crimes that occur on our premises.

Coroners and Medical Examiners

We may disclose your medical information to coroners or medical examiners to assist in identifying a deceased person or determining the cause of death.

Funeral Directors

We may disclose your medical information to funeral directors as necessary for them to carry out their duties.

Organ, Eye, or Tissue Donation

To facilitate organ, eye, or tissue donation and transplantation, we may disclose your medical information to relevant organizations involved in these activities.

Research (if applicable)

Under certain circumstances, we may use or disclose your medical information for research purposes. Before doing so, the research project will undergo an approval process to ensure that your privacy is protected. We may also disclose your information to someone preparing to conduct research to help them plan the project, but no medical information will leave IAMACOMEBACK, LLC during this process.

To Avert a Serious Threat to Health or Safety

We may use or disclose your medical information if we believe it is necessary to prevent or lessen a serious or imminent threat to the health or safety of a person or the public. We may also release information if necessary for law enforcement authorities to identify or apprehend someone involved in a violent crime or who has escaped from lawful custody.

Specialized Government Functions

We may disclose your medical information to authorized federal officials for national security reasons, including intelligence and counter-intelligence activities. Other permitted disclosures may relate to matters of national security.

Workers' Compensation

We may disclose your medical information as necessary to comply with workers' compensation and similar laws that provide benefits for work-related injuries or illnesses.

Other Uses and Disclosures

Any other uses and disclosures of your medical information not described in this notice will be made only with your written authorization. You may revoke such authorization at any time by notifying IAMACOMEBACK, LLC in writing. However, if you revoke your authorization, it will not affect any actions we have already taken based on your prior consent.

Your Rights With Respect to Medical Information About You

You have the following rights regarding the medical information we maintain about you:

Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your medical information for treatment or healthcare operations. You can also request restrictions on disclosures to family members, relatives, close friends, or others involved in your care. To request a restriction, submit your request in writing to IAMACOMEBACK, LLC, 7810 Goldenview Circle, Amarillo, TX 79119, specifying what information you want to limit, how you want the limit to apply, and to whom the limits should apply.

We are not required to agree to your request, but if we do, we will follow the restriction unless the information is needed for emergency treatment. Either you or we may later terminate the restriction.

Right to Receive Confidential Communications

You have the right to request that we communicate with you in a specific way or at a specific location. For example, you can ask that we contact you only by mail, at work, or at a specific email address or phone number. We will accommodate your request. To request confidential communication, submit your request in writing to IAMACOMEBACK, LLC, 7810 Goldenview Circle, Amarillo, TX 79119, specifying how or where you wish to be contacted.

Right to Inspect and Copy

You have the right to inspect and obtain a copy of your medical information. To do so, submit your request in writing to IAMACOMEBACK, LLC, 7810 Goldenview Circle, Amarillo, TX 79119, specifying the information you want to inspect or copy. We may charge a fee for the costs of copying and, if applicable, mailing the information.

We will act on your request within 30 calendar days. If we grant your request, we will inform you and provide access to the information. If we deny your request, we will inform you of the reason, how you can have the denial reviewed, and how to file a complaint. If you request a review of our denial, a licensed healthcare professional not involved in the denial will conduct the review, and we will comply with the outcome.

Right to Amend

You have the right to request an amendment to your medical information if you believe it is inaccurate or incomplete. To request an amendment, submit your request in writing to IAMACOMEBACK, LLC, 7810 Goldenview Circle, Amarillo, TX 79119, specifying the amendment you want and the reason for it.

We will act on your request within 60 calendar days. If we grant your request, we will inform you and make the appropriate amendment to your medical information