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.
Ace Audiology, PLLC is committed to protecting the privacy of your health information. This Notice of Privacy Practices (“Notice”) explains how Ace Audiology, PLLC may use and disclose your protected health information (“PHI”), your rights regarding your PHI, and our responsibilities regarding the privacy of your health information.
I understand that, under the Health Insurance Portability & Accountability of 1996 (“HIPAA”), I have certain rights to privacy regarding my PHI. I understand that this information can and will be used to:
- Conduct, plan and direct my treatment and follow up among the multiple healthcare providers who may be involved in that treatment directly and indirectly. We will receive your written consent prior to making disclosures outside our practice for treatment purpose, except in emergencies.
- Payment includes the activities needed to obtain reimbursement for the provision of hearing healthcare. We may use or disclose your health information to obtain payment for healthcare services. We will obtain written consent prior to making disclosures for payment purposes.
- Conduct normal healthcare operations such as quality assessments and physician certifications. We may use or share your information for health research.
If you have any questions regarding our privacy practices or think we may have violated your privacy rights, please contact us at:
Ace Audiology, PLLC
(407) 557-5770
aceaudiologypllc@gmail.com
You may also submit a complaint to the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be retaliated against for filing a privacy complaint.
This Notice of Privacy Practice requires us to:
- Maintain the privacy of your protected health information and provide you with this notice.
- Follow the terms of the Notice currently in effect.
- Notify you as required by law following a breach of unsecured protected health information. If a breach of your unsecured protected health information occurs, Ace Audiology, PLLC will provide notification as required by applicable federal and state law.
We reserve the right to change our privacy practices and make the revised Notice applicable to protected health information we maintain. If we make a material change to our privacy practices, we will update this Notice and make the revised Notice available as required by law.
There is a copy of Ace Audiology’s privacy practices available upon request.
You have the following rights regarding your protected health information, subject to certain legal limitations:
- You may request in writing that you restrict how private information is used or disclosed to carry out treatment, payment, marketing, or health care operations. Ace Audiology, PLLC is not required to agree to requested restrictions unless you are bound to abide by such restrictions.
- You can ask us to contact you in a specific way (for example, home, office, or cell phone, by text or email) or to send mail to a different address. We will say “yes” to all reasonable requests.
- You may request a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
Acknowledgment of receipt of Notice of Privacy Practices regarding protected health information
Photocopies of this document are to be as valid as the original.
Established September 2025
Revised August 2026