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.
Ozark Health and Wellness, PLLC, doing business as Ozark Men's Health ("we," "us," or "our"), is required by law to maintain the privacy of your protected health information ("PHI"), to provide you with this Notice describing our legal duties and privacy practices with respect to PHI, and to abide by the terms of the Notice currently in effect.
How We May Use and Disclose Your Health Information
Treatment. We may use and disclose your PHI to provide, coordinate, or manage your care. For example, we may share information with a laboratory (such as Quest Diagnostics or Access Labs) to order and receive your test results, or with a pharmacy to fill a prescription.
Payment. We may use and disclose your PHI to bill and collect payment for services, including verifying eligibility for HSA/FSA reimbursement.
Health Care Operations. We may use and disclose your PHI for activities such as quality assessment, staff training, and practice management.
Other Permitted or Required Uses and Disclosures Without Your Authorization. In limited circumstances, the law permits or requires us to use or disclose your PHI without your authorization, including: when required by law; for public health activities (such as reporting as required by the Arkansas Department of Health); to report suspected abuse, neglect, or domestic violence; for health oversight activities; in connection with judicial or administrative proceedings in response to a valid order; for law enforcement purposes as permitted by law; to coroners, medical examiners, or funeral directors as necessary; to avert a serious threat to health or safety; for specific government functions (such as military or national security purposes, if applicable); in connection with workers' compensation programs; and to business associates who perform services on our behalf (such as our EHR, billing, and fax/communications vendors) under a written agreement requiring them to protect your information.
Family, Friends, and Others Involved in Your Care. Unless you object, we may share information directly relevant to your care or to payment for your care with a family member, friend, or other person you have involved in your care. We may also use or disclose limited information to notify such a person of your location or general condition, or to assist in disaster relief efforts.
Research, Organ Donation, and Decedents. We may use or disclose PHI for research when permitted by law and approved through the required review process, for organ and tissue donation purposes, and to a coroner, medical examiner, or funeral director as necessary to carry out their duties.
Appointment Reminders and Health-Related Information. We may contact you to provide appointment reminders, and to tell you about treatment alternatives or other health-related benefits and services that may be of interest to you. You may ask us to stop these communications at any time.
All Other Uses and Disclosures Require Your Written Authorization. Any use or disclosure of your PHI not described above — including most uses of psychotherapy notes, uses for marketing, and any sale of PHI — requires your specific written authorization. You may revoke an authorization at any time in writing, except to the extent we have already relied on it.
Your Rights Regarding Your Health Information
- Right to Request Restrictions. You may ask us to restrict how we use or disclose your PHI for treatment, payment, or operations. We are not required to agree, except that we must agree to a restriction on disclosure to a health plan for a service you paid for in full, out of pocket, if the disclosure is not otherwise required by law.
- Right to Request Confidential Communications. You may ask us to communicate with you in a specific way or at a specific location (for example, by contacting you only at a certain phone number or email address).
- Right to Inspect and Copy. You have the right to inspect and obtain a copy of your PHI in our records, with limited exceptions. Because we keep your record electronically, you may ask for an electronic copy, and you may direct us in writing to send a copy to a person or organization you designate. We may charge a reasonable, cost-based fee for copies.
- Right to Amend. You may ask us to amend your PHI if you believe it is incorrect or incomplete. We may deny the request in certain circumstances, and will explain our reasons in writing.
- Right to an Accounting of Disclosures. You may request a list of certain disclosures we have made of your PHI, other than for treatment, payment, operations, and certain other excepted categories. The accounting covers up to six years before the date of your request, and one accounting in any twelve-month period is provided free of charge.
- Right to a Paper Copy of This Notice. You may request a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
- Right to Be Notified of a Breach. We are required to notify you if a breach of your unsecured PHI occurs.
To exercise any of these rights, contact our Privacy Officer using the information below. We will respond within the timeframes required by law.
Our Duties
We are required by law to maintain the privacy of your PHI, provide you with this Notice of our legal duties and privacy practices, and abide by the terms of the Notice currently in effect. We reserve the right to change the terms of this Notice and to make the revised Notice effective for PHI we already maintain, as well as PHI we receive in the future. If we make a material change, we will post the revised Notice on our website and make it available at our office.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services, Office for Civil Rights (HHS OCR). You will not be retaliated against in any way for filing a complaint.
To file a complaint with us, contact our Privacy Officer using the information below.
To file a complaint with HHS OCR, visit www.hhs.gov/ocr/complaints, call 1-800-368-1019, or write to: U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Washington, D.C. 20201.
Adverse Event Reporting
If you experience an adverse reaction, side effect, or other safety concern related to a medication or treatment you received through our practice, contact us immediately at the phone number below so we can address it as part of your care. Adverse events involving a prescription medication may also be reported directly to the FDA's MedWatch program at www.fda.gov/medwatch or 1-800-FDA-1088. Adverse events related to a pharmacy's dispensing of your medication can also be reported to that pharmacy directly.
Privacy Officer and Contact Information
Ozark Health and Wellness, PLLC, d/b/a Ozark Men's Health
Attn: Privacy Officer (Cody Tompkins, APRN, FNP-BC)
240 S Main Street, Bentonville, AR 72712
Phone: (479) 446-6972
Email: info@ozarkmenshealth.com
Last updated: September 30, 2026