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.

Last Update: 10/15/2026

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 an electronic or paper copy of your medical record. You can ask to see or get 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, 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. 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, home or mobile phone, text, or email) 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 operations. We will say “yes” unless a law requires us to share it.
  • 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 those about treatment, payment, and health care operations and certain others (such as any you asked us to make). We provide one accounting a year for free but may charge a reasonable, cost-based fee if you ask for another within 12 months.
  • Get a copy of this privacy notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive it electronically.
  • 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.
  • Be notified of a breach. You have the right to be notified if there is a breach of your unsecured health information.
  • File a complaint if you feel your rights are violated. You can complain by contacting our Privacy Officer using the information 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 or payment 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 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.
  • Use or disclosure of photographs or video of you, other than for your medical record and care.

In the case of fundraising: we may contact you for fundraising efforts, but you can tell us not to contact you again.

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. Example: A provider evaluating you for hormone therapy reviews your laboratory results, or we share information with a pharmacy filling your prescription.
  • Run our organization. We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information to send appointment reminders, review the quality of our services, and train staff.
  • Bill for your services. We can use and share your health information to bill and get payment from health plans or other entities, and to manage your account for self-pay services. Example: We give information about you to your health plan so it will pay for covered services.

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.

  • Help with public health and safety issues, such as preventing disease, helping with product recalls, reporting adverse reactions to medications or devices, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone’s health or safety.
  • Do research. We can use or share your information for health research when the law allows.
  • 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 are complying with federal privacy law.
  • Respond to organ and tissue donation requests and work with a medical examiner or funeral director.
  • Address workers’ compensation, law enforcement, and other government requests. We can use or share health information about you 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.
  • 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.
  • Work with our business associates. We may share information with vendors who perform services for us, such as laboratories, billing, electronic health records, and scheduling or messaging services, under written agreements that require them to protect your information.

Substance use disorder treatment records
If we receive or maintain records about you that are protected by federal confidentiality rules for substance use disorder treatment programs (42 CFR Part 2), we will not use or share those records, or testimony about their content, in any civil, criminal, administrative, or legislative proceeding against you unless you give written consent or a court orders it after notice and an opportunity for you to be heard, as required by law. If you consent once to the use of these records for treatment, payment, and health care operations, we may further use and share them as permitted by HIPAA.

State law
Florida law may give certain information, such as HIV/AIDS test results, mental health records, and some genetic or sexually transmitted infection information, greater protection than federal law. When state law is more protective of your privacy, we will follow it.

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. 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, in our office, and on our website.

Contact Information

If you have questions about this notice, wish to exercise any of your rights, or want to file a complaint, please contact:
Privacy Officer: Gerald F. Horton Jr., MD
MD AGE Management, 1345 Clay St, Winter Park, FL 32789
Phone: (407) 369-8994

This notice applies to MD AGE Management and its physicians, providers, and staff.