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.

CarePrime Men LLC (the "Practice") is committed to protecting the privacy of your health information. This Notice of Privacy Practices describes how we may use and disclose your protected health information ("PHI"), your rights regarding that information, and our legal duties with respect to your PHI. We are required by law to maintain the privacy of your PHI, to provide you with this Notice, and to abide by the terms of the Notice currently in effect.

The Practice provides telehealth services through Christopher Brown, FNP, a board-certified family nurse practitioner. In states that grant nurse practitioners full practice authority, NP Brown may practice independently. In states that do not grant full practice authority, such as Georgia as of the Effective Date of this Notice, NP Brown practices under the supervision of a licensed physician, currently Caleb Brown, M.D., which supervising physician may change from time to time. As of the Effective Date of this Notice, the Practice offers services only to patients located in Georgia, with the potential for expansion into additional states as the Practice obtains licensure. The Practice operates on a cash-pay, subscription basis and does not bill health insurance.

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 an electronic or paper copy of your medical record.

• You can ask to see or receive an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
• 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. Ask us how to do this.
• 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, personal cell phone or personal email) or to send mail to a different address.
• We will accommodate 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" if it would affect your care.
• Because the Practice is cash-pay and does not submit claims to health insurers, this right will typically not be implicated in the ordinary course of your care. If you ever ask us to share information with a health plan and you have paid out-of-pocket in full for the related item or service, we will honor your request not to share that information unless a law requires us to do so.

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 prior to the date you ask, who we shared it with, and why.
• We will include all disclosures except for 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 per year at no charge but may charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this 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 you have given someone medical power of attorney, or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will confirm that the person has authority to act for you before we take any action.

File a complaint if you feel your rights are violated.

• You can file a complaint by contacting us at the address or phone number listed at the end of this Notice.
• 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 described 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
• 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

Our Uses and Disclosures

How do we typically use or share your health information?

Treat you. We can use your health information and share it with other professionals who are treating you, including your supervising physician where applicable (currently Caleb Brown, M.D., in states that do not grant NP Brown full practice authority), and the pharmacies and laboratories that fulfill your prescriptions and lab orders.

Example: Your nurse practitioner shares your relevant health history with the compounding pharmacy filling your prescription so the pharmacy can safely prepare and ship your medication.

Run our organization. We can use and share your health information to run our practice, improve your care, and contact you when necessary, including to coordinate your subscription services, lab orders, and medication fulfillment.

Example: We use health information about you to manage your treatment and services, including through our electronic health record and patient portal.

Bill for your services. The Practice is a cash-pay, subscription-based practice and does not bill health insurance plans for your care. We use your information to process your subscription payment and to communicate with the pharmacies and laboratories that bill the Practice directly for medications and lab testing furnished to you.

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, visit: www.hhs.gov/hipaa/for-individuals/index.html.

Help with public health and safety issues, including:

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone's health or safety

Do research. We can use or share your information for health research, subject to applicable law and oversight requirements.

Comply with the law. We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we're complying with federal privacy law.

Respond to organ and tissue donation requests. We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director. We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers' compensation, law enforcement, and other government requests, including:

• For workers' compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions. We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Notice regarding redisclosure. Please be aware that once we disclose your health information to another person or entity as permitted by HIPAA, including a pharmacy or laboratory that fulfills your care, that information may be redisclosed by the recipient and may no longer be protected by HIPAA.

Records Received from Substance Use Disorder (SUD) Treatment Programs

CarePrime Men LLC is not itself a federally assisted substance use disorder treatment program subject to 42 U.S.C. § 290dd-2 and 42 C.F.R. Part 2 ("Part 2"). However, if you disclose substance use disorder treatment history to us, or if we receive records from another provider or program that is subject to Part 2, federal law restricts our ability to use or further disclose that specific information, even though we are not a Part 2 program ourselves.

Information we receive that is subject to Part 2 may generally be redisclosed only:

• With your written consent that meets Part 2's requirements;
• Consistent with a Part 2-compliant consent already obtained by the program that disclosed the information to us;
• In a medical emergency;
• Pursuant to a qualified court order that meets Part 2's requirements; or
• As otherwise expressly permitted by Part 2.

Any Part 2-protected record we receive will be treated as subject to a notice prohibiting its further disclosure without your written consent or as otherwise permitted by Part 2. Part 2-protected information may not be used to initiate or substantiate any criminal charges against you, or to conduct any criminal investigation of you, except as authorized by a court order meeting Part 2's requirements.

Where Part 2 is more protective of a record than HIPAA, we will follow Part 2's requirements with respect to that specific record.

Multi-State Practice

You are receiving services from a nurse practitioner licensed to practice in the state where you are located at the time of your visit. As of the Effective Date of this Notice, the Practice offers services only to patients located in Georgia, with the potential for expansion into additional states in the future. Where a state's law affords greater privacy protection to your health information than federal law (HIPAA), we will comply with that more protective state law with respect to your information.

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. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

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 upon request and posted on our website at all times.

Complaints

If you believe we have violated your privacy rights, or if you disagree with a decision we made about your records, you may contact us at:

CarePrime Men LLC
Attn: Christopher Brown, FNP-BC
127 F St, Suite 213, Brunswick, GA 31520
Phone: 912-298-2957
Email: admin@careprimemen.com

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights:

• Mail: 200 Independence Avenue, S.W., Washington, D.C. 20201
• Phone: 1-877-696-6775
• Web: www.hhs.gov/ocr/privacy/hipaa/complaints/

You will not be penalized in any way for filing a complaint.

For more information about your privacy rights under HIPAA, visit: www.hhs.gov/hipaa/for-individuals/index.html.

This Notice satisfies the requirements of 45 C.F.R. § 164.520.