HIPPA
Notice of Privacy Practices
Updated Date: August 1, 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.
Your Information. Your Rights. Our Responsibilities.
This notice describes how medical information about you may be used and disclosed by MedClub by Dr. Jenn LLC, and how you can get access to this information. Please review it carefully.
We never market or sell your personal health information.
Your Rights
You have the right to:
- Get a copy of your paper or electronic medical record
- Correct your paper or electronic medical record
- Request confidential communication
- Ask us to limit the information we share
- Get a list of those with whom we’ve shared your information
- Get a copy of this privacy notice
- Choose someone to act for you
- File a complaint if you believe your privacy rights have been violated
Your Choices
You have some choices in the way that we use and share information as we:
- Tell family and friends about your condition
- Provide disaster relief
- Include you in a hospital directory
MedClub by Dr. Jenn LLC does not market our services using your health information, and we never sell your information.
Our Uses and Disclosures
We may use and share your information as we:
- Treat you
- Run our organization
- Bill for your services
- Help with public health and safety issues
- Do research
- Comply with the law
- Respond to organ and tissue donation requests
- Work with a medical examiner or funeral director
- Address workers’ compensation, law enforcement, and other government requests
- Respond to lawsuits and legal actions
Your Rights (Details)
Get an electronic or paper copy of your medical 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. Contact us using the information at the bottom of this notice.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical 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’ll 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, office, or cell phone) 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 to your request, and we may say “no” — for example, if it could affect your care. If we agree to your request, we may still share this information if you need emergency treatment.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
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 the six years prior to your request, 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’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one 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 have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
If someone has authority to act as your personal representative — such as through medical power of attorney or legal guardianship — that person can exercise your rights and make choices about your health information. We will verify this authority before taking 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 us using the information at the bottom of this notice.
- You can 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 https://www.hhs.gov/hipaa/filing-a-complaint/index.html.
- We will not retaliate against you for filing a complaint.
Your Choices (Details)
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, talk to us. 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 payment for your care
- Share information in a disaster relief situation
- Include your information in a hospital directory
If you are not able to tell us your preference — for example, if you are unconscious — we may share your information if we believe it is in your best interest, or 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
MedClub by Dr. Jenn LLC does not conduct fundraising activities.
Our Uses and Disclosures (Details)
Treat you
We can use your health information and share it with other professionals treating you. Example: A provider treating you for an injury asks another provider about your overall health condition.
Run our organization
We can use and share your health information to run MedClub by Dr. Jenn LLC, improve your care, and contact you when necessary.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
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 must meet many legal conditions before sharing your information for these purposes.
Help with public health and safety issues — such as preventing disease, product recalls, reporting adverse drug reactions, reporting suspected abuse/neglect/domestic violence, and preventing or reducing a serious threat to anyone’s health or safety.
Pharmacies — we can submit your information to pharmacies so they can fill your prescriptions properly.
Comply with the law — we will share information about you if state or federal law requires it, including with HHS to verify our compliance with federal privacy law.
Respond to organ and tissue donation requests — we can share health information with organ procurement organizations.
Work with a medical examiner or funeral director — when an individual dies.
Address workers’ compensation, law enforcement, and other government requests — for workers’ compensation claims, law enforcement purposes, health oversight agencies, and special government functions such as military, national security, and presidential protective services.
Respond to lawsuits and legal actions — we can share health information in response to a court or administrative order, or a subpoena.
Electronic Health Records
We maintain your health information electronically through a HIPAA-compliant third-party electronic health record (EHR) system. Any vendor with access to your information is contractually required, through a Business Associate Agreement, to safeguard it in accordance with HIPAA.
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 in this notice unless you tell us we can in writing. You may change your mind at any time by notifying us in writing.
For more information, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
Changes to the Terms of this Notice
MedClub by Dr. Jenn LLC 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 upon request and on our website.
Contact Us
MedClub by Dr. Jenn LLC Palm Beach, Florida
Email: [email protected] Phone: 561-214-3323
This notice is provided for informational purposes as a HIPAA-compliant template and should be reviewed by a healthcare attorney familiar with Florida law before being finalized and published, particularly to confirm whether any Florida-specific confidentiality statutes (e.g., regarding mental health or HIV-related records) require additional disclosures beyond federal HIPAA requirements.