Notice of Privacy Practices

Magnusson Clinic PLLC · Effective Date: September 1, 2026 · Print this notice

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.

At Magnusson Clinic PLLC (“Practice,” “we,” or “us”), we understand that information about you and your health is personal, and we are committed to protecting it. We create a record of the care and services you receive so that we can provide you with quality care and comply with legal requirements. This Notice of Privacy Practices (“Notice”) applies to all records of your care generated by the Practice. It explains how we may use and disclose your protected health information (“PHI”), and it describes your rights and our obligations regarding that information.

Our Legal Duties

We are required by law to maintain the privacy of your PHI, to give you this Notice of our legal duties and privacy practices, and to follow the terms of the Notice currently in effect. We reserve the right to change this Notice and to make the revised Notice effective for all PHI we maintain. If we make a material change, we will post the updated Notice in our office and on our website, and you may request a copy at any time.

Your Rights Regarding Your Health Information

Right to Request Restrictions

You may request that we restrict how we use or disclose your PHI for treatment, payment, or health care operations. Submit your request in writing to our Privacy Officer, stating (1) what information you want to limit, (2) whether you want to limit use, disclosure, or both, and (3) to whom the restriction should apply. We are not required to agree to every requested restriction, except as noted immediately below.

Right to Restrict Disclosure of Self-Paid Services Required by law

If you pay out-of-pocket in full for a specific item or service, you have the right to request that we not disclose PHI relating to that item or service to your health plan for payment or health care operations. We are required to honor this request, except where disclosure is otherwise required by law.

Right to Request Confidential Communications

You have the right to request that we communicate with you about your health in a certain way or at a certain location, for example, by contacting you only at your work address. Submit your request in writing to the Privacy Officer. We will accommodate reasonable requests.

Right to Inspect and Copy

You generally have the right to inspect and copy your PHI that we maintain. Submit your request in writing to the Privacy Officer; we may charge a reasonable, cost-based fee for copies. Consistent with federal information-blocking regulations, we will make your electronic health information, including clinical notes and test results, available to you without unreasonable delay through our patient portal, except in the limited circumstances permitted by law. If we deny access, we will explain the basis for the denial and, where applicable, your right to have the denial reviewed.

Right to Amend

If you believe PHI we maintain about you is incorrect or incomplete, you may request that we amend it. Submit your request in writing to the Privacy Officer with the reason for the amendment. We may deny your request in certain circumstances, for example, if the information was not created by us, is not part of our records, or is accurate and complete. If we deny your request, we will provide a written explanation and inform you of your rights.

Right to an Accounting of Disclosures

You have the right to request a list of certain disclosures of your PHI made during the six years prior to your request. The list will not include disclosures made for treatment, payment, or health care operations, disclosures made to you or with your authorization, or certain other disclosures permitted by law. Submit your request in writing to the Privacy Officer. The first accounting in any 12-month period is free; we may charge a reasonable, cost-based fee for additional requests.

Right to Breach Notification Required by law

You have the right to be notified if we, or one of our business associates, discover a breach of your unsecured PHI that may have compromised the privacy or security of your information.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice at any time, even if you have agreed to receive it electronically. To obtain one, contact the Privacy Officer using the information at the end of this Notice.

How We May Use and Disclose Your Health Information

We may use or disclose your PHI for the purposes described below without your written authorization.

For Treatment

We may use and disclose your PHI to provide, coordinate, or manage your care, including sharing information with other health care providers involved in your treatment.

For Payment

We may use and disclose your PHI to bill and obtain payment for the services we provide, for example, giving information to your health plan so it will pay for your care, or sharing information with billing companies and claims processors that assist us.

For Health Care Operations

We may use and disclose your PHI for our operations, such as quality assessment and improvement, staff and provider evaluation and training, care coordination, compliance and risk management, credentialing, and general administration.

As Required by Law and for Law Enforcement

We may use or disclose your PHI when required by law, when ordered in a judicial or administrative proceeding, or in response to a properly documented and limited request from a law enforcement agency.

For Public Health Activities

We may disclose your PHI to public health authorities for purposes such as recording births and deaths, preventing or controlling disease, and notifying persons who may have been exposed to a communicable disease.

For Health Oversight Activities

We may disclose your PHI to government agencies for oversight activities authorized by law, such as audits, investigations, inspections, and licensure or disciplinary actions.

To Avoid a Serious Threat to Health or Safety

We may use and disclose your PHI when necessary to prevent or lessen a serious and imminent threat to the health or safety of you or the public, to someone able to help prevent or lessen the threat.

For HIPAA Compliance Investigations

We must disclose your PHI to the U.S. Department of Health and Human Services when it requests the information to investigate our compliance with federal privacy regulations.

To Persons Involved in Your Care

Unless you object, we may disclose PHI relevant to your care to a family member, relative, friend, or other person you identify as involved in your health care or in payment for your care.

Other Uses and Disclosures

Uses and disclosures not described in this Notice will be made only with your written authorization. Certain categories, such as most uses and disclosures of psychotherapy notes, uses and disclosures for marketing, and any disclosure that would constitute a sale of PHI, always require your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it. We are required to retain records of the care we provide to you.

Your Right to File a Complaint

We value your privacy and the trust you place in us, and we make every effort to resolve any concern you may have. If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the federal government. We will not retaliate against you, and you will not be penalized, for filing a complaint.

Privacy Officer, Magnusson Clinic PLLC

You may also file a complaint with the Office for Civil Rights, U.S. Department of Health and Human Services. Regional office contact information is available at www.hhs.gov/ocr/about-us/contact-us/index.html.

Please contact the Privacy Officer if you have any questions about this Notice or your privacy rights.