HIPPA PRIVACY NOTICE

Liftique Naturelle(tm) M.D., and Liftique(tm)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.

WHO WILL FOLLOW THIS NOTICE?

This notice describes the practices of Liftique Naturelle M.D., also referred to or known as Liftique, and the practices that will be followed by all of Liftique Naturelle, M.D., workforce members who handle your medical information.

OUR PLEDGE REGARDING YOUR PROTECTED HEALTH INFORMATION

Liftique Naturelle, M.D. understands that medical information about you and your health is personal. We are committed to protecting medical information about you. We maintain our records and conduct our treatment environment with a goal of providing the best level of protection for your medical information, while still providing you with the highest level of medical care. This notices applies to all of the records of your medical care which are received or created by Liftique Naturelle, M.D.

Your other medical treatment providers (e.g. doctors, hospitals, home health agencies, etc.) may have different policies or notices regarding the use and disclosure of your medical information.

This notice will tell you about the ways in which Liftique Naturelle, M.D., may use and disclose medical information about you. Your medical information, also referred to as “protected health information” is that information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health information and related health care services.

In this notice, we also describe your rights and certain obligations Liftique Naturelle,,MD, has regarding the use and disclosure of your protected health information. We are required by name to:

  1. Make sure that medical and other information that identifies you (protected health information) is kept private.

  2. Give you this notice of our legal duties and privacy practices with respect to protected health information about you.

  3. Follow the terms of the notice that is currently in effect.

USES AND DISCLOSURES FOR TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS

By becoming a patient at Liftique Naturelle M.D., you are giving consent for Liftique Naturelle, M.D. to use your protected health information for certain activities, including treatment, payment and other health care operations. First of all, we may use and disclose protected health information about you so that Liftique Naturelle, M.D., and its medical professionals can treat you. For example, we may use your past medical information in order to diagnose your present condition or we may provide information regarding your medical condition to another doctor to whom we refer you for additional care. We may also use and disclose protected health information about you so that we may be paid for the medical treatment we provide you. We may also use and disclose protected health information about you for Liftique Naturelle MD., health care operations, in other words, those other tasks that we need to perform to make sure that you are provided the highest quality of medical care. For example, we may use your protected health information to evaluate how we can better meet your needs or we may provide protected health information about you to an auditor who reviews our books so that we can keep our license to provide medical services in California.

Other uses and disclosures of your protected health information

The following uses of your protected health information may be made without any additional authorization from you. (Not every use or disclosure is listed, but be assured that all uses and disclosures made by Liftique Naturelle M.D., are only those which are permitted under the law).

Licensure proceedings by the American Board of Plastic Surgery.

Uses and disclosures for appointment reminders

We may use and disclose your medical information to contact you as a reminder that you have an appointment at the office. If you request that such communications be made confidentially, please contact our office in writing at 3701 Birch Street, Newport Beach, CA 92660. We will accommodate all reasonable requests.

Uses and disclosures to others involved in your healthcare

We may disclose to a member of your family, a relative, a close friend, or any other person you identify, your protected health information that directly relates to that person’s involvement in your medical care. If you are unable to agree or object to this disclosure, we may disclose such information as necessary if we determine that it is in your best interests based on our professional judgment. We may also use or disclose protected health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition, or death. Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.

Uses and disclosures in emergency situations

We may use or disclose your protected health information in an emergency treatment situation. If this happens, your physician will attempt to obtain your acknowledgment of this Notice as soon as reasonably practicable after the delivery of treatment.

Uses and disclosures for health-related benefits or services

From time to time, Liftique Naturelle M.D., may use and disclosure protected health information to tell you about certain health related benefits or services that may be of interest to you.

Uses and disclosures required by law

We will use or disclose protected health information about you when required to do so by federal, state, or local law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, if the law requires us to do so, of any such uses or disclosures. We must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the law.

Uses and disclosures related to communicable diseases

We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

Disclosures for health oversight activities

We may disclose protected health information to a health oversight agency for activities authorized by law. These activities include, for example, audits, investigations, and inspections. These activities are necessary for the government to monitor the health care system, the delivery of health care, government benefit programs, other government regulatory programs and civil rights laws.

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​Disclosures to the food and drug administration

We may disclose your protected health information to a person or company required by the Food and Drug Administration (FDA) to report adverse events, product defects or other problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements; or to conduct post-market surveillance, as required.

Disclosures for lawsuits and disputes

If you are involved in a lawsuit or a dispute, we may disclose protected health information about you in response to a court order or administrative order. We may also disclose protected health information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Disclosures to law enforcement

We may release protected health information if asked to do so by a law enforcement official, in response to a court order, subpoena, warrant, summons, or similar process. Other related disclosures may include disclosures relating to individuals who are Armed Forces personnel, to national security and intelligence agencies, as well as disclosures to authorized federal officials for the protection of the President of the United States or other authorized persons or foreign heads of state.

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Disclosures for research

We may disclose your protected health information to researchers when their research has been approved and protocols have been established to ensure the privacy of your information. We may also disclose a limited set of your information, as allowed under the law, for research purposes.

Disclosures related to criminal activity

We may disclose your protected health information, consistent with federal and California laws, if we believe that the use or disclosure is necessary to prevent or lessen a serious or imminent threat to the health or safety of a person or the public, or if it is necessary for law enforcement authorities to identify or apprehend an individual.

Disclosures for Workers’ Compensation

We may release protected health information about you for Workers’ Compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.

Your rights regarding protected health information about you

Right to inspect and copy

You have the right to inspect and copy protected health information that may be used to make decisions about your medical care. Usually this right includes both medical and billing records. You must submit your request in writing. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. Your request to inspect and copy your information may only be denied in very limited circumstances and you have a right to request that any such denial be reviewed.

Right to request restrictions

You have the right to request that we restrict the use and disclosure of your protected health information for treatment, payment and health care operations. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

To request restrictions, you must make your request in writing to 3701 Birch Street, Newport Beach, CA 92660. In your request, you must tell us:

  1. What information you want to limit

  2. Whether you want to limit our use, disclosure, or both.

  3. To whom you want the limits to apply.

Right to confidential communications

You also have the right to request to receive private health information communications (such as appointment confirmations) by alternative means or at alternative locations. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing to 3701 Birch Street, Newport Beach, CA 92660. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to amend

If you feel that the protected health information we have about you is incorrect or incomplete, you have the right to request that your protected health information be amended. Only the health care entity (e.g., doctor, hospital, clinic, etc.) that created your protected health information is responsible for amending it. For more information regarding the procedures for submitting such a request, contact 3701 Birch Street, Newport Beach, CA 92660.

Right to an accounting of disclosures

You have a right to an accounting of disclosures of your protected health information, for purposes other than treatment, payment or health care operations by Liftique Naturelle, M.D.,or any of the people or companies who perform treatment, payment or health care operations on our behalf. To request this list of disclosures we made of protected health information about you, you must submit a request in writing to 3701 Birch Street, Newport Beach, CA 92660. Your request must state a time period which may not be longer than six (6) years prior to the date of your request and may not include dates before January 1, 2017 . Your request should indicate the form in which you want the list (for example, on paper or electronically). You will be charged for photocopying.

Right to a paper copy of this notice

You have the right to a paper copy of this Notice. You may ask us to give you a copy of this notice at any time.

You may obtain a copy of this Notice at our website: http://www.liftiquenaturelle.com

To obtain a paper copy of this Notice, contact 844-454-3847

To learn more about these procedures, or to make any of these requests, you should contact our Office Manager at 844-484-4487.

Changes to this notice

Liftique Naturelle, M.D., reserves the right to change this notice. We reserve the right to make the revised or changed Notice effective for protected health information we already have about you, as well as any information we create or receive in the future. We will post a copy of the current Notice on Liftique Naturelle, M.D., website: http://www.liftiquenaturelle.com. The Notice will contain, in the top right-hand corner, the effective date.

Complaints

If you believe your privacy rights have been violated and/or that Liftique Naturelle MD, has not followed this policy, you may file a complaint with Liftique Naturelle, M.D. Office Manager or with the Secretary of the Department of Health and Human Services.

To file a complaint with Liftique Naturelle contact Office Manager, 3701 Birch Street, Newport Beach, CA 92660. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

Other uses of protected health information

Other uses and disclosures of your protected health information not covered by this notice or the laws that apply to Liftique Naturelle, M.D. will be made only with your written permission (“authorization”). If you provide us permission to use or disclose protected health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose protected health information about you for the reasons covered by your authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the medical treatment or other services that we have provided to you.


Data use opt in policy

By inquiring about Liftique services or by requesting or downloading Liftique offered educational materials using social platforms such as Facebook or Instagram or by registering for a Liftique educational event or by “Opting In” to and by providing your cell phone or email to Liftique for any of the above reasons or additional inquiries methods, you are expressly agreeing to this inquiry as the first step to potentially establishing a business relationship with Liftique and thus agreeing to opt in and be contact by a Text Message Service and/or Email Service, and thus you accept these Terms & Conditions and agree to resolve disputes with Liftique Naturelle through binding arbitration (and with very limited exceptions, not in court), and you waive any right to participate in class actions, all as detailed in the “Disputes” section below.

Definitions

  • “Text Message Service” includes any arrangement or situation in which Liftique sends (or indicates that it may send, or receives a request that it send) one or more text messages.
  • “Opting In,” “Opt In” and “Opt-In” refer to requesting, joining, agreeing to, enrolling in, signing up for, acknowledging, or otherwise consenting to receive one or more text messages.
  • “Liftique” means Liftique Naturelle LLC and Liftique Naturelle Clinic, Inc

By providing your contact information per the terms above you are expressly opting In to Liftique Text Message Service and email services, thus

  • You authorize Liftique to use autodialer or non-autodialer technology to send text messages to the cell phone number associated with your information provided. You also authorize Liftique to include marketing content in any such messages. You do not have to Opt In or agree to Opt In as a condition of purchase, your providing information to learn more will be considered your Opt in to establish a business relationship with Liftique.
  • You confirm that you are the subscriber to the relevant phone number or that you are the customary user of that number on a family or business plan and that you are authorized to Opt In and receive Text messages.
  • To withdraw your consent, or to update our records with your contact information, please call 1-844-454-3847.

After providing your contact information which is your agreement to Opt In and receive messages from Liftique, in addition to the main messages the service offers, you may receive one or more welcome messages or administrative messages, such as (in some cases) a request to confirm your Opt-In.

About the Text Message Services and Opting Out

Message and data rates may apply. Unless otherwise noted, Text Message Services send multiple, recurring messages. Liftique may terminate any Text Message Service or your participation in it at any time with or without notice, including, for example, before you have received any or all messages that you otherwise would have received, but these Terms & Conditions still will apply. 

At any time you can opt out by texting STOP to any Liftique text message received. Your opt-out request may generate either a confirmation text or a texted request to clarify the Text Message Service to which it applies (if you have more than one). To complete your opt-out, please provide the requested clarification.

You consent to the handling of your information is described in the Liftique Privacy Policy. To contact Liftique customer service, call 1-844-454-3847) You must be 18 years of age or older (except Alabama and Nebraska, where you must be 19 years of age or older).

Disputes

Any dispute or claim arising out of or relating in any way to a Text Message Service will be resolved by binding arbitration, rather than in court, except that you may assert claims in small claims court if your claims qualify. The Federal Arbitration Act and federal arbitration law apply to these Conditions of Use.

BY AGREEING TO ARBITRATION, YOU UNDERSTAND AND AGREE THAT YOU ARE WAIVING YOUR RIGHT TO MAINTAIN OTHER AVAILABLE RESOLUTION PROCESSES, SUCH AS A COURT ACTION OR ADMINISTRATIVE PROCEEDING, TO SETTLE ANY DISPUTES OR CLAIMS. THE RULES IN ARBITRATION ARE DIFFERENT. THERE IS NO JUDGE OR JURY. ALTHOUGH REVIEW IS LIMITED, AN ARBITRATOR CAN AWARD ON AN INDIVIDUAL BASIS THE SAME DAMAGES AND RELIEF AS WOULD BE AVAILABLE IN COURT, AND MUST ENFORCE THE SAME LIMITATIONS STATED IN THESE CONDITIONS OF USE AS A COURT WOULD.

To begin an arbitration proceeding, you must send a demand to the American Arbitration Association (AAA) describing your claim and serve a copy of the demand on our registered agent CT Corporation System, Inc., 100 South Fifth Street, Suite 1075, Minneapolis, MN 55402. The arbitration will be conducted by the AAA under its rules, including the AAA’s Supplementary Procedures for Consumer-Related Disputes. The AAA’s rules and the form for filing an arbitration claim are available at www.adr.org or by calling 1-800-778-7879. Payment of all filing, administration and arbitrator fees will be governed by the AAA’s rules. We will reimburse those fees (but not any attorney’s fees) for claims totaling less than $10,000 unless the arbitrator determines your claims are frivolous. Likewise, Liftique will not seek attorneys’ fees and costs in arbitration unless the arbitrator determines the claims are frivolous. You may choose to have the arbitration conducted by telephone, based on written submissions, or in person in the county where you live or at another mutually agreed upon location.

We each agree that any dispute resolution proceedings of any nature or in any forum will be conducted only on an individual basis and not in a class, consolidated or representative action. This means that you may not purport to act on behalf of a class or any other person. Likewise, an arbitrator may not consolidate more than one person’s claims, and may not otherwise preside over any form of a representative or class proceeding.

If for any reason a claim proceeds in court rather than in arbitration, we each waive any right to a jury trial, unless such waiver is unenforceable. This means that any claim would be decided by a judge, not a jury.

We also both agree that you or we may bring suit in court to seek to enjoin infringement or other misuse of intellectual property rights.

Applicable Law

THE FEDERAL ARBITRATION ACT AND APPLICABLE FEDERAL LAW (OR IN THE ABSENCE OF APPLICABLE FEDERAL LAW, THEN THE LAWS OF THE STATE OF MINNESOTA), WITHOUT REGARD TO PRINCIPLES OF CONFLICT OF LAWS, WILL GOVERN THESE TERMS & CONDITIONS AND APPLY TO ANY DISPUTES OR CLAIMS AGAINST LIFTIQUE ARISING OUT OF OR RELATING IN ANY WAY TO ANY LIFTIQUE TEXT MESSAGE SERVICE.

Facebook may use lead ad data as permitted by its Data Policy including to pre-fill future instant forms individuals may complete. Facebook does not use the data from advertiser’s Custom Questions.

Under the General Data Protection Regulation (GDPR), is Facebook the data controller or data processor for lead ads?

In the case of lead ads, both Facebook and the advertiser are data controllers. As a result, both parties are responsible for ensuring compliance by providing notice and establishing a legal basis for processing the data provided by a person using our platform. The lead ads product gives advertisers an option to link to their privacy policies and terms related to the collection and use of personal data.

Questions?

If you have any questions regarding this notice, please contact the Office Manager at Liftique Naturelle.

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