CAERUS WELLNESS, LLC d/b/a Level Up Express Care

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.

This Notice applies to protected health information maintained by the covered health care operations of CAERUS WELLNESS, LLC d/b/a Level Up Express Care. Independent health care providers or entities that are not covered by this Notice may provide their own privacy notice.

Privacy Contact

• Privacy Officer: Tamara Alicea Nieves
• Organization: CAERUS WELLNESS, LLC d/b/a Level Up Express Care
• Mailing Address: 5592 Berwood Dr, Orlando, FL 32810
• Email: [PRIVACY CONTACT EMAIL - REQUIRED BEFORE PUBLICATION]
• Phone: [PRIVACY / SUPPORT PHONE - REQUIRED BEFORE PUBLICATION]
• Website: https://levelupexpresscare.com

You may contact the Privacy Officer to ask questions about this Notice, exercise a privacy right, or make a privacy complaint. We will not retaliate against you for exercising your rights.

Your Rights

You may, subject to applicable law:

• inspect or obtain an electronic or paper copy of your medical record;
• ask us to amend information you believe is incorrect or incomplete;
• request confidential communications;
• ask us to restrict certain uses or disclosures;
• request an accounting of certain disclosures for the prior six years;
• obtain a paper copy of this Notice;
• use a legally authorized personal representative;
• file a privacy complaint without retaliation; and
• discuss this Notice with our Privacy Officer.

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

Your Choices

When applicable, you may tell us your preference about sharing information with family members, close friends, others involved in your care or payment, and disaster-relief organizations.

If you cannot tell us your preference, we may make a limited disclosure when permitted by law and when we reasonably believe it is in your best interest, or when needed to lessen a serious and imminent threat to health or safety.

How We May Use or Disclose Your Information

We may use or disclose your health information, as permitted or required by law, for:

• treatment and care coordination;
• payment and billing;
• health care operations;
• public health and safety activities;
• health oversight and authorized government functions;
• workers' compensation;
• legal or administrative proceedings;
• lawful law-enforcement requests;
• coroners, medical examiners, funeral directors, and organ/tissue donation;
• research when applicable legal requirements are met; and
• disclosures required by law, including disclosures to HHS for HIPAA compliance.

Uses Requiring Authorization or Special Permission

We will obtain written authorization for uses or disclosures that are not otherwise permitted or required by law. Authorization is generally required for certain uses of psychotherapy notes, sales of protected health information, and marketing activities that require authorization. You may revoke an authorization in writing, except to the extent we already acted in reliance on it.

If we contact you for fundraising using information permitted by law, you may opt out of future fundraising communications.

Substance Use Disorder Records - 42 CFR Part 2

To the extent we create, receive, or maintain substance use disorder patient records protected by 42 CFR Part 2, those records receive additional federal confidentiality protections. We will not use or disclose Part 2 records in civil, criminal, administrative, or legislative investigations or proceedings against you unless the disclosure is permitted by Part 2, including through your written consent or a qualifying court order and subpoena. Other Part 2 consent, redisclosure, breach, and fundraising rules will be followed when applicable.

Florida Privacy Protections

Florida law may provide additional confidentiality protections for patient records. We will follow any state or federal law that is more protective of your information. In general, Florida law restricts disclosure of patient records except to the patient or legal representative, to health care practitioners and providers involved in care when permitted, under a valid written authorization, or under another disclosure expressly permitted or required by law.

Telehealth records are maintained and protected under the same applicable professional, medical-record, privacy, and security requirements that govern the services provided.

Our Responsibilities

We are required by law to maintain the privacy and security of protected health information, provide required breach notices, follow the current Notice, provide a copy upon request, and use reasonable safeguards.

Changes to This Notice

We may change this Notice and our privacy practices. A revised Notice may apply to information we already maintain and information we receive in the future. We will update the effective date and make the current Notice available as required by law.

Complaints

You may complain to Level Up Express Care by contacting the Privacy Officer above. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue, S.W., Washington, DC 20201, 1-877-696-6775, or at https://www.hhs.gov/hipaa/filing-a-complaint/index.html.

We will not retaliate against you for filing a complaint.

Electronic Delivery

If you agree to receive this Notice electronically, an electronic return receipt, acknowledgment, or other electronic transmission may document receipt. You may request a paper copy at any time.