Notice of Privacy Practices
Your Privacy. Our Responsibility.
This Notice explains how medical information about you may be used and disclosed, and how you can access this information. Please review it carefully.
Effective Date: August 1, 2020
Our Commitment to Your Privacy
At Advanced Medicine Modern Aesthetics (AMMA), we respect your privacy and are deeply committed to protecting your personal health information. We comply fully with the Health Insurance Portability and Accountability Act (HIPAA) and all applicable privacy laws.
This Notice of Privacy Practices describes how your protected health information (PHI) may be used and disclosed, your rights regarding that information, and our legal obligations.
If you have any questions about this Notice, please contact:
Anna Stankiewicz, MD
📞 (757) 279-7276
✉️ hello@amma.vip
This Notice applies to all records created or maintained by AMMA, including information generated by our physicians, staff, contractors, volunteers, and medical director.
Our Legal Responsibilities
We are required by law to:
Safeguard the privacy of your protected health information
Provide you with this Notice outlining our privacy practices
Comply with the terms of this Notice currently in effect
How We May Use and Disclose Your Information
The following outlines the primary ways we may use and disclose your health information. Not every situation is listed, but all uses fall within these categories.
Treatment
We may use or share your information to provide, coordinate, or manage your medical care. This may include communication with physicians, nurses, or other healthcare professionals involved in your treatment.
Payment
We may use or disclose your information to bill for services provided and to receive payment.
Healthcare Operations
Your information may be used for internal operations essential to delivering high-quality care, such as quality improvement initiatives, training, audits, and customer service.
Appointment Reminders & Care Information
We may contact you to confirm appointments or share information about treatment options or wellness services that may be relevant to your care.
Individuals Involved in Your Care
With your permission—or when appropriate—we may share information with family members, close friends, or others involved in your care or payment for care.
Business Associates
We may share information with trusted service providers who support our operations. These partners are contractually obligated to protect your privacy.
Legal & Public Health Requirements
We may disclose information when required by law, including for public health reporting, safety concerns, or regulatory compliance.
Safety & Emergency Situations
Information may be disclosed to prevent a serious threat to your health or the safety of others.
Law Enforcement & Legal Proceedings
We may disclose information in response to court orders, subpoenas, or other lawful requests as permitted by law.
Military, Veterans & National Security
Information may be disclosed as required for military service members, veterans’ affairs, or national security activities.
Workers’ Compensation
We may disclose information for workers’ compensation or similar programs.
Coroners & Funeral Directors
Information may be released to assist with identification or determination of cause of death.
Marketing & Sale of Information
We will never use or sell your health information for marketing purposes without your explicit written authorization.
Change of Ownership
If AMMA is sold or merged, your records may transfer to the new owner. Your rights regarding your information remain unchanged.
Other Uses
Any use or disclosure not outlined above requires your written authorization.
Your Rights
You have the following rights regarding your health information:
Access & Copies
You may request to inspect or obtain copies of your medical and billing records. Requests must be made in writing. Reasonable fees may apply.
Amendments
You may request corrections to your records if you believe information is inaccurate or incomplete.
Disclosure Accounting
You may request a list of certain disclosures made within the past six years, excluding those related to treatment, payment, or operations.
Restrictions
You may request limits on how your information is used or shared. We are not required to agree to all requests, except where services are paid in full out-of-pocket.
Confidential Communications
You may request that we contact you in a specific manner or location.
Breach Notification
You will be notified if a breach involving your unsecured health information occurs.
Paper Copy
You may request a printed copy of this Notice at any time.
Changes to This Notice
We reserve the right to update this Notice at any time. Any revisions will apply to both current and future records and will be posted in our office and on our website.
Complaints
If you believe your privacy rights have been violated, you may file a complaint without fear of retaliation.
Contact:
Anna Stankiewicz, MD
Advanced Medicine Modern Aesthetics
5239 Monticello Ave
Williamsburg, VA 23188
You may also contact the U.S. Department of Health and Human Services:
https://www.hhs.gov/ocr/privacy/hipaa/complaints/
Authorization & Revocation
Uses or disclosures not covered by this Notice require your written authorization. You may revoke authorization at any time, except for disclosures already made.
Acknowledgment of Receipt
Patients are asked to acknowledge receipt of this Notice upon establishing care with Advanced Medicine Modern Aesthetics.