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.

1. Our Duties

Offer Empire, LLC is committed to maintaining the privacy of your Protected Health Information (PHI). We provide you with notice of our privacy practices with respect to PHI and will notify you in the event of a breach of unsecured PHI. We abide by the terms of this Notice while it is in effect.

2. How We May Use and Disclose Your PHI

Treatment: We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services. For example, we share your intake information with the licensed physician reviewing your case and with the compounding pharmacy fulfilling your prescription. Payment: We may use and disclose your PHI to obtain payment for services. Healthcare Operations: We may use and disclose your PHI for our internal operations, including quality assessment, training, and compliance activities. Required by Law: We will disclose your PHI when required to do so by federal, state, or local law.

3. Your Rights Regarding Your PHI

You have the right to: (a) Request a restriction on certain uses and disclosures of your PHI; (b) Receive confidential communications of your PHI; (c) Inspect and obtain a copy of your PHI; (d) Request an amendment to your PHI; (e) Receive an accounting of disclosures of your PHI; (f) Receive a paper copy of this Notice; and (g) File a complaint if you believe your privacy rights have been violated.

4. How to Exercise Your Rights

To exercise any of the rights described above, submit a written request to: Empire Health Privacy Officer, support@empire.health. We will respond within 30 days. We may charge a reasonable cost-based fee for copies of records.

5. How to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with Empire Health or with the Secretary of the U.S. Department of Health and Human Services. To file with Empire Health, contact our Privacy Officer at support@empire.health. You will not be retaliated against for filing a complaint.

6. Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have about you as well as any information we receive in the future. We will post the current Notice on our website. You may request a copy at any time.

7. Contact

Empire Health Privacy Officer: support@empire.health. Mailing address: Offer Empire, LLC, 1309 Coffeen Avenue STE 1200, Sheridan WY 82801 USA