Effective: March 1, 2026

This Notice describes how your medical information (Protected Health Information or “PHI”) may be used and disclosed and how you can access this information. This Notice applies to all PHI maintained by Aloha Functional Medicine and Wellness, PLLC.

We are required by federal law (HIPAA) to:

• Maintain the privacy of your PHI

• Provide this Notice of our legal duties and privacy practices

• Follow the terms of this Notice

• Notify you in the event of a breach involving your unsecured PHI

1. Your Rights Regarding PHI

You have the right to:

A. Access Your Records

You may request to view or obtain copies of your medical records.
We must provide access within 30 days unless extended for a legal reason.

B. Request Corrections

If you believe your records contain inaccuracies, you may request a correction.
We may deny requests if the record is accurate or legally maintained.

C. Request Confidential Communications

You may request that we communicate with you in a specific way (e.g., alternate phone number).

D. Request Restrictions

You may request limits on how we use or disclose your PHI.
We are not required to agree to all restrictions unless required by law.

E. Accounting of Disclosures

You may request a list of disclosures made in the past 6 years, except those made:

• For treatment

• For payment

• For healthcare operations

• Authorized by you

F. Paper or Electronic Copy of This Notice

You may request a paper or digital copy at any time.

G. Right to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with:

• Aloha Functional Medicine and Wellness, PLLC

• The U.S. Department of Health and Human Services (HHS)

You will not face retaliation for filing a complaint.

2. Our Responsibilities

We must:

• Follow HIPAA laws

• Protect the confidentiality, integrity, and security of your PHI

• Notify you of any breach involving your PHI

• Use or disclose PHI only as permitted by HIPAA

3. How We Use and Disclose PHI

We may use or disclose PHI for the following purposes:

A. Treatment

To provide, coordinate, or manage care, including:

• Telehealth visits

• Consultation with other providers

• Ordering labs or imaging

• Developing treatment plans

B. Payment

To obtain payment for services rendered, including:

• Billing

• Claims processing

• Payment collection

C. Healthcare Operations

For internal operations, including:

• Quality assessment

• Training

• Audits

• Administrative functions

D. Required by Law

We must disclose PHI when required by:

• Court orders

• Public health laws

• Reporting abuse or neglect

• Law enforcement

E. Public Health Activities

Includes:

• Disease reporting

• FDA reporting

• Preventing or controlling disease

F. Workers’ Compensation

PHI may be released as authorized by workers’ compensation laws.

G. Organ & Tissue Donation Requests

When applicable.

H. Research

Only with authorization or if approved by IRB with safeguards.

I. To Prevent Serious Threats

If necessary to prevent a serious threat to health or safety.

J. Special Government Functions

Includes military, national security, or correctional institutions when required.

4. Uses & Disclosures Requiring Authorization

You must sign a written authorization for:

• Psychotherapy notes

• Marketing purposes

• Sale of PHI

• Any use beyond the purposes stated above

You may revoke your authorization at any time.

5. Breach Notification

We will notify you promptly if your PHI is breached.

Notification includes:

• What happened

• What PHI was involved

• Steps you should take

• What we are doing to mitigate harm

6. Contact Information

For questions or to exercise your rights:
📧 info@AlohaFunctionalMedicineAndWellness.com