Notice of Policy Practices

Healthy Self Clinic
Healthy Self Weight Loss, LLC
Medical Weight Loss, Wellness & Peptide Therapy

Palm Desert Location
73071 Fred Waring Drive
Palm Desert, CA 92260

La Quinta Location
79255 Highway 111, Suite 2
La Quinta, CA 92253

Phone: (760) 777-7766
Website: https://healthyself.com

Effective Date: November, 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.

1. Who Follows This Notice

This Notice of Privacy Practices applies to Healthy Self Weight Loss, LLC, operating as Healthy Self Clinic (“Healthy Self,” “we,” “us,” or “our”), and its healthcare providers, employees, contractors acting as members of its workforce, and other authorized workforce members.

This notice applies to protected health information (“PHI”) created, received, maintained, or transmitted by Healthy Self in connection with healthcare services, including in-person visits, telephone communications, electronic health records, patient communications, and telehealth services when offered.

Healthy Self Clinic and Well Trim Clinic are separate healthcare organizations. Patient information is not automatically shared between these organizations. Any disclosure must be authorized by the patient or otherwise permitted or required by applicable law.

2. Our Legal Duties

Under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), applicable regulations, and California privacy laws, Healthy Self is required to:

Maintain the privacy and security of protected health information.
Provide patients with this notice of our legal duties and privacy practices.
Follow the terms of the Notice of Privacy Practices currently in effect.
Notify affected individuals following a breach of unsecured PHI as required by law.
Comply with applicable federal and California requirements governing medical information.

We reserve the right to change this notice. Revised notices may apply to PHI we already maintain and information we receive in the future.

The current version will be available at our clinic locations and on our website. Patients may request a paper copy at any time.

3. How We May Use and Disclose Your Health Information

Treatment

We may use and disclose PHI to provide, coordinate, or manage your healthcare.

Examples include:

Reviewing medical history and laboratory results.
Evaluating patients for medical weight-management services.
Coordinating treatment with licensed healthcare professionals.
Sending prescriptions to authorized pharmacies.
Discussing treatment plans and follow-up care.
Referring patients to other healthcare providers when appropriate.

Payment

We may use and disclose PHI to obtain payment for healthcare services.

Examples include processing patient payments, maintaining billing records, and resolving payment-related matters.

Healthcare Operations

We may use and disclose PHI for activities necessary to operate our healthcare practice.

These activities may include:

Quality improvement.
Clinical and administrative staff training.
Compliance and auditing.
Patient service coordination.
Business management.
Healthcare-related administrative activities.

Appointment Reminders and Healthcare Communications

We may contact patients regarding:

Scheduled appointments.
Follow-up visits.
Prescription-related matters.
Treatment coordination.
Healthcare services and treatment alternatives.

Communications may occur by telephone, text message, email, patient portal, or other appropriate methods.

Marketing communications requiring authorization under HIPAA or consent under applicable communications laws will be handled separately. This notice does not constitute consent to receive promotional text messages.

Business Associates

Healthy Self may engage third-party vendors to provide services involving PHI, including electronic health records, patient scheduling, communications, payment administration, and technology support.

When HIPAA requires it, we will enter into written Business Associate Agreements requiring these vendors to safeguard PHI.

Individuals Involved in Your Care

Unless you object, we may disclose relevant PHI to a family member, friend, caregiver, or other person involved in your care or payment for your care, as permitted by law.

We may also use professional judgment when the patient is unavailable or unable to communicate.

4. Other Uses and Disclosures Permitted or Required by Law

Healthy Self may disclose PHI without your written authorization when permitted or required by applicable law, including:

Required by law: To comply with federal, California, or local legal requirements.

Public health: For disease reporting, public health investigations, and reporting certain medication-related adverse events.

Abuse or neglect: To authorized agencies when reporting is required or permitted by law.

Health oversight: For audits, licensing investigations, inspections, and regulatory oversight.

Judicial and administrative proceedings: In response to qualifying court orders, subpoenas, or other lawful processes.

Law enforcement: In circumstances specifically authorized by law.

Serious threats to health or safety: When legally permitted to prevent or lessen a serious and imminent threat.

Coroners and medical examiners: For legally authorized duties.

Organ and tissue donation: When applicable and legally permitted.

Research: When authorized or permitted through applicable privacy safeguards.

Specialized government functions: For certain military, national security, or other legally authorized purposes.

Workers’ compensation: As permitted by applicable workers’ compensation laws.

All disclosures remain subject to applicable HIPAA and California restrictions.

5. Uses and Disclosures Requiring Written Authorization

Healthy Self generally will obtain your written authorization before:

Using or disclosing PHI for marketing when HIPAA requires authorization.
Selling PHI. Healthy Self does not sell protected health information.
Using or disclosing psychotherapy notes, if maintained, except as otherwise permitted by law.
Using or disclosing PHI for purposes not otherwise permitted or required by law.

You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on that authorization.

6. Additional Protections Under California Law

Healthy Self complies with applicable California medical privacy laws, including the Confidentiality of Medical Information Act (“CMIA”), as well as HIPAA.

Certain categories of information may receive additional legal protection, including:

Mental health information.
HIV-related and certain communicable disease information.
Genetic testing information.
Substance use disorder treatment records.
Reproductive health information.
Other specially protected medical information.

Where California law or another applicable law provides stronger privacy protections than HIPAA, Healthy Self will follow the stricter applicable requirement.

We will not use or disclose PHI for purposes prohibited by applicable federal or California law.

7. Your Rights Regarding Your Health Information

Right to Inspect and Obtain Copies

You may request access to medical and billing records maintained in a designated record set.

Under HIPAA, we generally must respond within 30 days. California law may require faster access, including inspection within five working days and copies within 15 days for qualifying requests, subject to applicable exceptions.

Reasonable, legally permitted fees may apply.

Right to Request an Amendment

You may request correction or amendment of information you believe is inaccurate or incomplete.

We generally will respond within 60 days under HIPAA, subject to permitted extensions.

If we deny your request, we will provide a written explanation and information about your rights.

Right to an Accounting of Disclosures

You may request an accounting of certain disclosures of your PHI during the preceding six years.

Some disclosures, including many made for treatment, payment, and healthcare operations, are excluded under applicable rules.

One accounting generally is available without charge during a 12-month period.

Right to Request Restrictions

You may request restrictions on certain uses or disclosures of your PHI.

We are not generally required to agree, except when you request that we not disclose information to your health plan about a service or item you paid for completely out of pocket, and the disclosure is not otherwise required by law.

Right to Confidential Communications

You may request that Healthy Self communicate with you through a specific method or at a specific location.

We will accommodate reasonable requests as required by law.

Right to a Paper Copy

You may request a paper copy of this notice at any time, even if you previously agreed to electronic delivery.

Right to Appoint a Personal Representative

An individual legally authorized to act on your behalf may exercise your privacy rights, subject to applicable verification and legal requirements.

Right to Breach Notification

You have the right to receive notification following a breach of unsecured PHI when required by law.

8. Electronic Communications, Website Forms, and Telehealth

Healthy Self may use electronic systems to manage healthcare records, scheduling, patient communications, and telehealth services where offered.

We implement administrative, physical, and technical safeguards appropriate to the systems and information involved.

However, ordinary email and text messaging may not provide the same protections as secure patient communication systems.

Patients may request alternative communication methods.

Website forms and electronic communications should not be used for medical emergencies.

For a medical emergency, call 911.

Electronic communication preferences and any required consent will be handled in accordance with applicable law.

9. Privacy Complaints

If you believe your medical privacy rights have been violated, you may file a complaint with Healthy Self Clinic or the U.S. Department of Health and Human Services.

Healthy Self Clinic — Privacy Officer
Healthy Self Weight Loss, LLC
Palm Desert, California
Phone: (760) 777-7766
Website: https://healthyself.com

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue SW
Washington, DC 20201

Phone: 1-877-696-6775
Website: https://www.hhs.gov/ocr/privacy/hipaa/complaints/

Healthy Self Clinic will not retaliate against any individual for filing a privacy complaint or exercising privacy rights.

10. Contact Information

For questions about this notice, requests for medical records, confidential communications, privacy concerns, or other privacy-related matters, please contact:

Healthy Self Clinic
Healthy Self Weight Loss, LLC

Palm Desert:
73071 Fred Waring Drive
Palm Desert, CA 92260

La Quinta:
79255 Highway 111, Suite 2
La Quinta, CA 92253