Notice of Privacy Practices

Effective date: October 8, 2026

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 and billing records

You can ask to see or get an electronic or paper copy of the health and billing records we keep about you. 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 records

You can ask us to correct health information about you that you think is incorrect or incomplete. We may say no, 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, such as by a different phone number, 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 health care item out of pocket in full, you can ask us not to share that information with your health insurer for payment or our operations. We will say yes unless a law requires us to share it.

Get a list of those with whom we have shared information

You can ask for a list, called an accounting, of the times we shared your health information in the six years before your request, who we shared it with, and why. The list will not include disclosures for 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 and may charge a reasonable, cost-based fee if you ask for another 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 agreed to receive it electronically. We will provide it 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 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 using the information at the end of this notice. You can also file a complaint with:

U.S. Department of Health and Human Services, Office for Civil Rights
200 Independence Avenue SW
Washington, D.C. 20201
Phone: 1-877-696-6775
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, talk to us and we will follow your instructions.

You have both the right and the 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 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.

We never share your information for marketing purposes or sell your information unless you give us written permission. We do not use your information for fundraising.

Our uses and disclosures

To treat you

We can use your health information and share it with other professionals who are treating you. For example, your anesthesia provider may share information with your surgeon and the hospital care team about how you are doing during and after your procedure.

To run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary. For example, we use health information to review the quality of our services.

To bill for your services

We can use and share your health information to bill and get payment from health plans or other entities. For example, we give information about you to your health insurance plan so it will pay for your anesthesia services.

Other ways we can use or share your 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.

• Public health and safety: 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
• Research: health research, under conditions set by law
• Complying with the law: when state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law
• Organ and tissue donation: responding to requests from organ procurement organizations
• Medical examiners and funeral directors: when an individual dies
• Workers' compensation, law enforcement, and other government requests: 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
• Lawsuits and legal actions: in response to a court or administrative order, or in response to a subpoena

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 by letting us know in writing.

For more information, see the U.S. Department of Health and Human Services guide for consumers at hhs.gov/hipaa/for-individuals.

Changes to 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, in our office, and on this website.

Privacy Officer

Questions, requests, or complaints about this notice can be directed to our Privacy Officer:

Privacy Officer
Integral Anesthesia, LLC
512 N Franklin St #100
Jenks, OK 74037
Phone: 1-800-683-5919
Email: info@integralanesthesia.org