Notice of Privacy Practices
Effective Date: June 1, 2026
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.
Our Commitment to Your Privacy
Aspire Rejuvenation is committed to protecting the privacy of your health information. We are required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations 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 your PHI, and to abide by the terms of this Notice.
How We May Use and Disclose Your Protected Health Information
We may use and disclose your PHI for the following purposes:
Treatment. We may use your PHI to provide, coordinate, or manage your healthcare and related services. This includes consultations between healthcare providers relating to your care, referrals to other providers, and coordination of services such as laboratory work, prescriptions, and other clinical services.
Payment. We may use and disclose your PHI to obtain payment for services we provide to you. This may include billing and collections activities, insurance verification, prior authorization requests, and communications with your health plan.
Healthcare Operations. We may use and disclose your PHI for our internal operations. This includes quality assessment and improvement, training, compliance programs, audits, licensing, credentialing, and other administrative activities necessary to run our practice.
Other Permitted Uses and Disclosures
We may also use or disclose your PHI without your authorization in the following circumstances as permitted or required by law:
- As required by law, including reporting to public health authorities, the Food and Drug Administration, or other regulatory agencies.
- For public health activities, such as preventing or controlling disease, injury, or disability.
- To report victims of abuse, neglect, or domestic violence to government authorities as required by law.
- For health oversight activities, including audits, investigations, inspections, and licensure proceedings.
- In connection with judicial and administrative proceedings, in response to a court order, subpoena, or other lawful process.
- For law enforcement purposes, as required or permitted by law.
- To coroners, medical examiners, and funeral directors as necessary to carry out their duties.
- For organ and tissue donation purposes, if you are an organ donor.
- For research purposes, under certain conditions and with appropriate safeguards.
- To prevent or lessen a serious and imminent threat to your health or safety or the health or safety of others.
- For specialized government functions, including military and veterans activities, national security, and protective services.
- For workers compensation purposes, as authorized by and to the extent necessary to comply with workers compensation laws.
Uses and Disclosures Requiring Your Written Authorization
We will obtain your written authorization before using or disclosing your PHI for purposes other than those described above, including marketing purposes, sale of PHI, and most uses of psychotherapy notes. You may revoke your authorization at any time by submitting a written request to our Privacy Officer. Revocation will not affect any actions we took in reliance on your authorization before we received your revocation.
Substance Use Disorder Records
If you receive treatment for a substance use disorder at our facility, records relating to that treatment may receive additional protections under 42 CFR Part 2, as aligned with current HIPAA regulations. These records will not be disclosed without your written consent except as permitted by applicable federal and state law.
Your Rights Regarding Your Protected Health Information
You have the following rights with respect to your PHI:
Right to Access. You have the right to inspect and obtain a copy of your PHI that is maintained in a designated record set. To request access, submit a written request to our Privacy Officer. We may charge a reasonable fee for copies. We will respond to your request within 30 days.
Right to Amend. You have the right to request that we amend your PHI if you believe it is incorrect or incomplete. To request an amendment, submit a written request to our Privacy Officer explaining the reason for the amendment. We may deny your request under certain circumstances and will provide a written explanation if we do.
Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we have made of your PHI. To request an accounting, submit a written request to our Privacy Officer. The first accounting in any 12 month period is free. We may charge a reasonable fee for additional requests.
Right to Request Restrictions. You have the right to request restrictions on certain uses and disclosures of your PHI for treatment, payment, or healthcare operations. You also have the right to request restrictions on disclosures to family members or others involved in your care. We are not required to agree to your request, except that we must agree to restrict disclosures to a health plan if you pay for the service in full out of pocket and the disclosure is not required by law.
Right to Request Confidential Communications. You have the right to request that we communicate with you about your health information in a certain way or at a certain location. For example, you may ask that we contact you only at your work address or via a specific phone number. We will accommodate reasonable requests.
Right to a Paper Copy of This Notice. You have the right to obtain a paper copy of this Notice upon request, even if you have agreed to receive this Notice electronically.
Right to Be Notified of a Breach. You have the right to be notified in the event that we discover a breach of your unsecured PHI. We will notify you of any such breach in accordance with applicable law.
Our Duties
We are required by law to:
- Maintain the privacy of your PHI.
- Provide you with this Notice of our legal duties and privacy practices with respect to your PHI.
- Abide by the terms of this Notice currently in effect.
- Notify you if we are unable to agree to a requested restriction on how your PHI is used or disclosed.
- Notify you in the event of a breach of your unsecured PHI.
We reserve the right to change our privacy practices and the terms of this Notice at any time. Any changes will apply to PHI we already hold as well as new information received after the change. If we make a material change to this Notice, we will post the revised Notice on our website and make it available at our clinic locations.
Filing a Complaint
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer using the contact information below. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints.
You will not be penalized or retaliated against for filing a complaint.
Privacy Officer Contact
If you have questions about this Notice or wish to exercise any of your rights, please contact our Privacy Officer:
Natalia Razurri, Office Manager and Privacy Officer
Email: natalia@aspirerejuvenation.com
Phone: (407) 233-4006
Clinic Locations:
- Orlando, FL: 8014 Via Dellagio Way, Suite 104, Orlando, FL 32819
- Pittsburgh (Wexford), PA: 180 Swinderman Rd, Suite 300, Wexford, PA 15090
- Dallas (Plano), TX: 5425 W. Spring Creek Pkwy, Suite 190, Plano, TX 75024
- Ebensburg, PA: 4478 Admiral Peary Highway, Ebensburg, PA 15931
