Notice of Privacy Practices

Download printable PDF

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.

Effective date: November 1, 2026

Sandhills Functional Medicine ("we," "us") is required by law to protect the privacy of your health information, to give you this notice of our legal duties and privacy practices, and to tell you if a breach affects your unsecured health information. We must follow the terms of the notice currently in effect. If you have questions, contact our Privacy Officer (see the end of this notice).

Your rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get a copy of your health record

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. Many records are also available in your patient portal. We will provide a copy or a summary, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your record

You can ask us to correct health information about you that you think is incorrect or incomplete. We may say "no" to your request, but we will tell you why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, home or cell phone, or portal only) or to send mail to a different address. We will say "yes" to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment or our operations. We are not required to agree, and we may say "no" if it would affect your care. If you pay for a service or item out of pocket in full, you can ask us not to share that information with your health insurer for payment or operations. We will say "yes" unless a law requires us to share it. Because we do not bill insurance, your visits and services here are paid out of pocket.

Get a list of those with whom we've shared information

You can ask for a list (accounting) of the times we've shared your health information for six years before the date you ask, who we shared it with, and why. We will include all disclosures except those about treatment, payment and health care operations, and certain other disclosures (such as any you asked us to make). We provide one accounting a year for free but may charge a reasonable, cost-based fee if you ask for another within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically. It is also posted at sandhillsfmteam.com/privacy and at our front desk.

Choose someone to act for you

If you have given someone medical power of attorney or someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority before we take any action.

File a complaint if you feel your rights are violated

You can complain if you feel we have violated your rights by contacting our Privacy Officer. You can 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/. We will not retaliate against you for filing a complaint.

Your choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations below, tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends or others involved in your care or in paying for your care.
• Share information in a disaster relief situation.

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases, we never share your information unless you give us written permission:

• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes

We do not conduct fundraising. If that ever changes, we may contact you, and you can tell us not to contact you again.

Our uses and disclosures

We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you. Example: your provider shares lab results with your primary care physician or a specialist, or sends a prescription to a pharmacy.

Run our practice

We can use and share your health information to run our practice, improve your care and contact you when necessary. Example: we review charts for quality, train staff, and send appointment reminders, lab-draw reminders and care updates by text, email, phone or the patient portal.

Bill for your services

We can use and share your health information to bill and get payment for your care. Sandhills Functional Medicine is a direct-pay practice and does not bill health insurance or Medicare. Example: we use your information to process membership payments and card payments, and to give you a receipt.

Work with our business associates

We use outside companies that help us run the practice, such as our electronic health record and patient portal, laboratories (such as Labcorp), compounding and fulfillment pharmacies, supplement suppliers, payment processors, and phone and messaging services. They must sign agreements to protect your information.

How else can we use or share your health information?

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information, see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

• Help with public health and safety issues, such as preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect or domestic violence, and preventing or reducing a serious threat to anyone's health or safety.
• Do research, when approved under the law and with privacy protections in place.
• Comply with the law, including sharing information with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.
• Respond to organ and tissue donation requests.
• Work with a medical examiner or funeral director when an individual dies.
• Address workers' compensation, law enforcement and other government requests, such as for workers' compensation claims, for law enforcement purposes or with a law enforcement official, with health oversight agencies for activities authorized by law, and for special government functions such as military, national security and presidential protective services.
• Respond to lawsuits and legal actions, such as in response to a court or administrative order, or in response to a subpoena.

North Carolina or federal law may give certain kinds of information extra protection, such as some mental health, HIV/communicable disease, genetic, and substance use disorder information. When those laws are stricter than this notice, we follow them.

Information shared outside our practice

When we share your health information with someone outside our practice as allowed by law, the person or organization that receives it may share it again, and it may no longer be protected by federal privacy law.

Our responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information, see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Changes to the terms of this notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available on request, at our front desk, on our website and in the patient portal.

Contact our Privacy Officer