HIPAA
— how we protect your information.

Effective Date:

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.

Our Commitment to Your Privacy

Reviv Med Spa & Laser Treatment is committed to protecting the privacy of your protected health information (PHI). We follow the requirements of the federal Health Insurance Portability and Accountability Act (HIPAA), as amended by the Health Information Technology for Economic and Clinical Health Act (HITECH), and applicable state laws.

How We Use Your Health Information

We use your health information for treatment, payment, and healthcare operations:

• Treatment. To provide, coordinate, and manage your care, including coordination with other providers when relevant.
• Payment. To collect payment for services. Reviv is a cash-pay practice; we do not bill insurance.
• Operations. Quality assessment, training, accreditation, business management, and administrative activities.

Disclosures Without Your Authorization

Limited disclosures are permitted by law without your authorization, including: public health activities, victims of abuse or neglect (as required by law), health oversight activities, judicial and administrative proceedings, law enforcement (limited circumstances), specialized government functions, and to coroners or funeral directors as required.

Your Rights Regarding Your Health Information

• Right to access. You may request a copy of your records.
• Right to amend. You may request corrections.
• Right to accounting of disclosures. You may request a list of certain disclosures.
• Right to request restrictions. You may request limits on how we use or disclose your information; we are not always required to agree.
• Right to confidential communications. You may request that we contact you in a specific way (alternative phone, email, etc.).
• Right to a paper copy. You may request a paper copy of this notice.

Photo & Image Use

Before-and-after photographs may be used for treatment-quality review, education, and (with explicit blanket-release consent) practice marketing. We obtain consent at the start of treatment series and maintain records of consent on file. You may revoke consent in writing at any time.

Breach Notification

We are required to notify you of any breach of unsecured PHI as required by HITECH and applicable state laws.

Changes to This Notice

We reserve the right to change this notice. The current notice is always available at this URL and posted in our facility.

How to File a Complaint

If you believe your privacy rights have been violated, contact us at the information below. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

Contact Us

Reviv Med Spa & Laser Treatment
Privacy Officer
31 S El Camino Real, Millbrae, CA 94030
(650) 697-3339
reviv@revivmedspa.com