Notice of Privacy Practices

Skin Deep RX

1102 W. 60 S., Suite 4, Tooele, UT 84074 · (435) 274-8897

Effective date: October 22, 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.

Our Duties

Skin Deep RX is required by law to:

• maintain the privacy of your protected health information (“health information”);

• give you this notice of our legal duties and privacy practices;

• follow the terms of the notice currently in effect;

• notify you if a breach occurs that may have compromised the privacy or security of your health information.

We will not use or share your information other than as described here unless you tell us we can in writing. We may change this notice. Changes will apply to all information we hold. The new notice will be posted on our website and in our office, and a copy is available on request.

How We May Use and Disclose Your Health Information

Treatment. We use and share your health information to provide care. Examples include:

• reviewing your labs and history to build your treatment plan;

• sending prescriptions to a pharmacy, including compounding pharmacies;

• coordinating with laboratories and other providers involved in your care.

Payment. We use and share information to bill and collect payment for services. Skin Deep RX is a cash-pay practice and does not bill insurance. If you ask, we can give you documentation to submit to your insurer or to a health savings or flexible spending account yourself.

Health care operations. We use and share information to run our practice, improve care, train staff, and conduct quality and compliance reviews. Examples include:

• appointment reminders;

• follow-up on your treatment;

• information about treatment options or services we offer that may interest you.

Business associates. We work with outside companies that perform services for us, such as our electronic health record and scheduling platform, laboratories, and IT providers. They are required by contract to protect your information.

Other Uses and Disclosures Permitted Without Your Authorization

We may share your information when required or permitted by law, including:

• as required by law (federal, state, or local);

• public health activities, such as reporting disease, adverse drug reactions, or product recalls;

• health oversight activities, such as audits, inspections, and licensure;

• abuse, neglect, or domestic violence reporting to authorized agencies;

• lawsuits and legal proceedings, in response to a court order, subpoena, or other lawful process;

• law enforcement, as permitted by law;

• to prevent a serious threat to health or safety;

• coroners, medical examiners, and funeral directors;

• organ and tissue donation;

• specialized government functions, such as military, national security, and protective services;

• workers’ compensation, as permitted by law.

Family and friends. Unless you object, we may share relevant information with a family member, friend, or other person involved in your care or payment for your care. If you are unable to tell us your preference, such as in an emergency, we may share information if we believe it is in your best interest.

Uses That Require Your Written Authorization

We will not do the following without your written authorization:

• use or share your information for marketing purposes;

• sell your information;

• use your name, photo, story, or results in testimonials, reviews, advertising, or social media;

• share psychotherapy notes, if any exist.

You may revoke an authorization in writing at any time. Revoking it does not undo anything we already did in reliance on it.

Your Rights

Get a copy of your health information. You may ask to see or get a paper or electronic copy of your medical record. We will provide it within 30 days. We may charge a reasonable, cost-based fee.

Ask us to correct your record. If you believe information is incorrect or incomplete, you may ask us in writing to amend it. We may deny the request, and if we do we will explain why in writing within 60 days.

Request confidential communications. You may ask us to contact you in a specific way, such as by cell phone only or at a different address. We will agree to all reasonable requests.

Ask us to limit what we use or share. You may ask us not to use or share certain information. We are not required to agree. If you pay for a service or item in full out of pocket, you may ask us not to share that information with your health insurer, and we will agree unless the law requires us to share it.

Get a list of those we’ve shared information with. You may ask for an accounting of certain disclosures we made in the six years before your request. This does not include disclosures for treatment, payment, or operations, or disclosures you authorized. One list per year is free. We may charge a reasonable fee for additional requests within 12 months.

Get a copy of this notice. You may ask for a paper copy at any time, even if you received it electronically.

Choose someone to act for you. If someone has your medical power of attorney or is your legal guardian, that person may exercise your rights. We will verify their authority before acting.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:

200 Independence Avenue SW, Washington, D.C. 20201
1-877-696-6775
www.hhs.gov/ocr/privacy/hipaa/complaints/

We will not retaliate against you for filing a complaint.

Contact

Privacy Officer: Julee Baird Kimball, MSN, APRN, FNP-C
Skin Deep RX, 1102 W. 60 S., Suite 4, Tooele, UT 84074
(435) 274-8897 · skindeeprx1@gmail.com