Notice of Privacy Practices
Vitali-T Men's Health Clinic (transitioning DBA to Vitali-T Health & Wellness Clinic) ("Vitali-T," "we," "us," or "our") is committed to protecting the privacy and security of your health information. We are required by law to maintain the privacy of your Protected Health Information ("PHI"), to provide you with this Notice of our legal duties and privacy practices with respect to PHI, and to notify you following a breach of unsecured PHI. This Notice applies to all records of care generated by Vitali-T Clinic, whether created in our physical location, through our telehealth platform, or through our patient portal, and to all providers, staff, and volunteers who work at or on behalf of Vitali-T.
1. How We May Use and Disclose Your Health Information
We use and disclose PHI about you for treatment, payment, and health care operations. Examples include:
| Category | What This Means for You |
|---|---|
| Treatment | We use your health information to provide, coordinate, and manage your care — for example, sharing your lab results and intake history with your prescribing provider, or coordinating with LabCorp, Quest Diagnostics, or our in-house lab in Astoria, OR to obtain and interpret your labs. |
| Payment | We use your information to bill you and process payment for services, including verifying eligibility for our self-pay programs and processing transactions through our payment processor. |
| Health Care Operations | We use information for quality improvement, provider training, compliance audits, and administering our patient portal and telehealth platform. |
We may also use or disclose your PHI, without your written authorization, in the following circumstances, each of which is limited by law:
- Business Associates: We share information with vendors who perform services on our behalf — such as our HIPAA-compliant telehealth/patient portal platform, compounding pharmacies that fill your prescriptions, and reference laboratories (LabCorp, Quest) — under a signed Business Associate Agreement requiring them to protect your information.
- As required by law (e.g., in response to a court order or subpoena).
- Public health activities (e.g., reporting as required by public health authorities, FDA adverse event reporting for medications).
- Health oversight activities (e.g., audits, licensure investigations).
- To avert a serious threat to health or safety of you or others.
- Judicial and administrative proceedings, in response to a valid legal order.
- Law enforcement purposes, under limited circumstances required by law.
- Coroners, medical examiners, and funeral directors, as necessary.
- Workers' compensation, as authorized by law.
- Family, friends, or others involved in your care, only if you agree or in an emergency, and limited to information directly relevant to their involvement.
2. Uses and Disclosures That Require Your Written Authorization
Other than the situations described above, we will not use or share your PHI without your written authorization. This includes, and you may revoke a prior authorization at any time in writing:
- Marketing communications that involve the sale or third-party promotion of products, where we receive payment for making the communication.
- Sale of your PHI — we do not sell your health information, and would never do so without your specific written authorization.
- Psychotherapy notes, if applicable to your care.
- Any other use not described in this Notice.
3. Your Rights Regarding Your Health Information
| Right | What It Means |
|---|---|
| Right to Inspect and Copy | You may request to inspect or receive a copy of your medical and billing records, generally within 30 days of your request, through our patient portal or by written request. |
| Right to Request Amendment | You may ask us to correct information you believe is incorrect or incomplete. We may deny the request in certain circumstances, but will provide our reasons in writing. |
| Right to an Accounting of Disclosures | You may request a list of certain disclosures we made of your PHI outside of treatment, payment, and health care operations, going back up to six years. |
| Right to Request Restrictions | You may ask us to limit how we use or disclose your PHI. We are not required to agree, except when you pay out of pocket in full for a service and ask us not to disclose that information to your health plan — in that case, we must honor the request. |
| Right to Request Confidential Communications | You may ask us to contact you in a specific way (e.g., personal cell phone rather than email) or at a different location. |
| Right to a Paper Copy | You may request a paper copy of this Notice at any time, even if you agreed to receive it electronically. |
| Right to Choose Someone to Act for You | If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights and make choices about your health information. |
| Right to Be Notified of a Breach | We will notify you if a breach occurs that may have compromised the privacy or security of your PHI, as required by law. |
4. Telehealth & Digital Platform Privacy
Because Vitali-T Clinic delivers care primarily through telehealth consultations and an online patient portal:
- We use HIPAA-compliant, encrypted platforms with signed Business Associate Agreements for video consultations, intake forms, and messaging.
- You are responsible for the privacy of your own environment and device during a telehealth visit — we recommend a private location and a secure, password-protected internet connection.
- Information you submit through our website's general contact forms, quizzes, or chat (before you become a patient) may not be protected as PHI in the same way as information submitted through our secure patient portal; please avoid including sensitive medical details in general website inquiries. See our separate Privacy Policy for how we handle website and marketing data as distinct from clinical PHI.
5. Our Responsibilities
- We are required by law to maintain the privacy and security of your PHI.
- We will let you know promptly if a breach occurs that may have compromised your information.
- We must follow the terms currently in effect in this Notice.
- We will not use or share your information other than as described here unless you tell us we can in writing, and you may revoke that permission in writing at any time.
6. Changes to This Notice
We reserve the right to change this Notice at any time and to make the revised Notice effective for all PHI we already have as well as any information we receive in the future. The current Notice is always available on our website at vitali-t.clinic/hipaa, in our patient portal, and available on request.
7. Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.
To file a complaint with Vitali-T Clinic, contact our Privacy Officer:
Terry Hollowell, Owner
Vitali-T Clinic
495 Olney Ave, Astoria, OR 97103
Phone: 503-902-5812
Email: terry@vitali-t.clinic
To file a complaint with the U.S. Department of Health and Human Services:
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: (877) 696-6775
Website:
www.hhs.gov/ocr/privacy/hipaa/complaints