Notice of Privacy Practices

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 health information maintained by Hustle and Muscle LLC, DBA Chez Michelle Injectables & Skin Studio. Protected health information identifies you and relates to your health, healthcare or payment for care. Website and marketing information are also addressed in our separate Privacy Policy.

Subject to applicable law, we may use and disclose health information to provide and coordinate care, obtain payment and run the practice. Examples include sharing relevant information with a treating clinician, processing payment and reviewing quality of care.

Service providers that handle protected information on the practice's behalf must meet applicable privacy requirements, including business-associate agreements where required. Appointment reminders and treatment communications are subject to your communication preferences and applicable law.

We may use or disclose health information when the applicable legal conditions allow or require it for public health and safety, reporting abuse or neglect, preventing a serious threat, health oversight, approved research, organ or tissue donation, coroners or funeral directors, workers’ compensation, and authorized government or judicial requests. Examples include reporting an adverse product reaction or responding to a legally valid court order. Each disclosure remains subject to the restrictions that apply to the record.

Washington law can provide additional protection for records relating to mental health, sexually transmitted diseases, and care for which a minor can consent independently. When such a record is involved, we obtain the authorization required by law or disclose it only under a specific permitted exception. The fact that information could be disclosed under HIPAA does not remove a more protective state restriction.

We apply the additional Washington disclosure protections that govern records of reproductive or gender-affirming care, including protections against prohibited out-of-state legal demands. These protections apply if the relevant information is present in a record; this notice does not state that the studio offers every type of care described. See Washington healthcare information law.

You may tell us your preferences about sharing information with people involved in your care or in disaster-relief circumstances. If you cannot express a preference, permitted disclosures may be made using professional judgment and the applicable legal limits.

Uses for marketing, sales of protected health information and most disclosures of psychotherapy notes require written authorization except where law permits otherwise. Other uses not covered by this notice also require authorization. You may revoke an authorization in writing, except to the extent action has already been taken in reliance on it.

If we receive substance use disorder patient records protected by 42 CFR Part 2, those records cannot be used or disclosed in investigations or proceedings against you without your written consent or the required court order and subpoena. Additional Part 2 protections may apply.

If Part 2 information is used for fundraising communications, advance clear notice and a choice about receiving those communications are required. This provision does not state that Chez Michelle Injectables & Skin Studio operates a substance use treatment or fundraising program.

You may request to inspect or obtain a paper or electronic copy of your health information. Submit a written request to Studio Management using the contact details below; call first if you need help arranging a secure request or delivery method. We verify your identity or representative authority before releasing records.

For Washington healthcare records, we act promptly and within 15 working days after a written access request. We provide access or the explanation, referral or denial allowed by law. If unusual circumstances cause a permitted delay, we explain why and give the earliest availability, no later than 21 working days after receipt. Any copy fee must be allowed by applicable law. See RCW 70.02.080.

You may ask in writing to correct or amend incomplete or inaccurate health information. Under Washington law, we respond promptly and within 10 days, or give the applicable explanation or a written delay notice identifying a disposition date no later than 21 days after receipt. If we refuse the requested change, we explain the decision and your right to add a statement of disagreement. See RCW 70.02.100.

You may request communications by a particular method or at a particular location. We will accommodate reasonable requests. You may also request limits on uses and disclosures. We are not required to agree to every restriction, but we must honor an applicable request not to disclose a service you paid for in full to a health plan for payment or healthcare operations, unless disclosure is required by law.

You may request an accounting of certain disclosures made during the preceding six years, excluding disclosures such as treatment, payment, healthcare operations and those you authorized. One accounting in a 12-month period is generally free; a reasonable cost-based fee may apply to additional requests after notice.

You can obtain a paper copy of this notice at any time, including if you previously accepted an electronic copy. An authorized personal representative can exercise rights for you after we verify that authority.

We are responsible for protecting health information, providing this notice, following the privacy practices currently in effect and notifying affected people of a breach when required. We will not use or disclose health information for a purpose outside this notice without the authorization required by law.

Information disclosed to a recipient may be redisclosed and may no longer be protected by HIPAA; other applicable protections may still apply. We may update this notice, and permitted changes may apply to information we already hold. The current version will be available at the studio, on this website and on request.

For privacy questions or requests, contact Studio Management at 425-696-3883, Chelly@chezmichelleboutique.com, or by mail to the studio address below. Include your name, a way to reach you and the type of request. Do not include medical records, full payment-card details or other sensitive information in ordinary email. We will arrange the appropriate method for any necessary records and verify identity or representative authority before releasing information.

You may complain to Studio Management or to the U.S. Department of Health and Human Services Office for Civil Rights. Visit HHS privacy complaints, call 1-877-696-6775, or write to 200 Independence Avenue SW, Washington, DC 20201. We will not retaliate against you for making a privacy complaint.

Hustle and Muscle LLC, DBA Chez Michelle Injectables & Skin Studio · 809 West Main Street, Suite D, Monroe, WA 98272 · 425-696-3883 · Chelly@chezmichelleboutique.com · chezmichelleboutique.com