HIPAA Notice of Privacy Practices
Family Tree Medical Group
Effective Date: May 14, 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.
Family Tree Medical Group is committed to protecting the privacy and security of your health information. This Notice of Privacy Practices explains how we may use and disclose your protected health information, also known as PHI, and describes your rights regarding your health information.
Protected health information includes information that identifies you and relates to your past, present, or future physical or mental health condition, health care services, or payment for health care services.
We are required by law to maintain the privacy and security of your protected health information, notify you if a breach occurs that may have compromised the privacy or security of your information, follow the terms of this Notice, and provide you with a copy of this Notice.
1. How We May Use and Disclose Your Health Information
We may use and disclose your health information for treatment, payment, and health care operations without your written authorization.
Treatment
We may use and disclose your health information to provide, coordinate, or manage your medical care.
Example: A Family Tree Medical Group provider may share your medical history, lab results, medication list, or diagnosis with another provider involved in your care.
Payment
We may use and disclose your health information to bill and collect payment for services we provide.
Example: We may send information to your health insurance company so they can process payment for your visit, lab work, procedures, or other covered services.
Health Care Operations
We may use and disclose your health information to operate our medical practice and improve patient care.
Example: We may use information for quality review, staff training, compliance, audits, credentialing, patient satisfaction, care coordination, or business management.
2. Other Uses and Disclosures Allowed or Required by Law
We may also use and disclose your health information without your written authorization in certain situations allowed or required by law.
Public Health Activities
We may disclose health information to public health authorities for disease prevention, reporting, investigations, or public health surveillance.
Required by Law
We may disclose health information when required to do so by federal, state, or local law.
Health Oversight Activities
We may disclose information to health oversight agencies for audits, investigations, inspections, licensing, or compliance reviews.
Abuse, Neglect, or Domestic Violence
We may disclose information to the appropriate authorities if we believe a patient may be a victim of abuse, neglect, or domestic violence, as required or permitted by law.
Legal Proceedings
We may disclose health information in response to a court order, subpoena, discovery request, or other lawful legal process.
Law Enforcement
We may disclose health information to law enforcement officials when required or permitted by law.
Coroners, Medical Examiners, and Funeral Directors
We may disclose health information to coroners, medical examiners, or funeral directors as necessary for them to perform their duties.
Organ and Tissue Donation
We may disclose health information to organizations involved in organ, eye, or tissue donation, when applicable.
Research
We may use or disclose health information for approved research purposes, subject to legal requirements and privacy protections.
Serious Threat to Health or Safety
We may use or disclose health information if necessary to prevent or reduce a serious and imminent threat to your health, safety, or the health and safety of others.
Workers’ Compensation
We may disclose health information as authorized by and necessary to comply with workers’ compensation laws.
Military, Veterans, National Security, or Protective Services
If applicable, we may disclose health information for military, national security, or protective service purposes as permitted by law.
Correctional Institutions
If you are in custody, we may disclose health information to correctional institutions or law enforcement officials as necessary for your health, safety, or the safety of others.
3. Uses and Disclosures That Require Your Written Authorization
We must obtain your written authorization before using or disclosing your health information for certain purposes, including:
Most uses and disclosures of psychotherapy notes, if applicable
Marketing communications, except where permitted by law
Sale of protected health information
Other uses and disclosures not described in this Notice
You may revoke your authorization in writing at any time. If you revoke your authorization, we will stop using or disclosing your information for the authorized purpose, except to the extent we already relied on your authorization.
4. Appointment Reminders and Health-Related Communications
We may use or disclose your health information to contact you about:
Appointment reminders
Follow-up care
Test results
Prescription refills
Treatment options
Health-related benefits or services
Practice updates related to your care
We may contact you by phone, voicemail, email, text message, mail, or other communication methods you provide, unless you request a different method and we agree to it.
5. Family Members, Caregivers, and Others Involved in Your Care
We may share relevant health information with a family member, caregiver, personal representative, or other person involved in your care or payment for your care, unless you object or unless prohibited by law.
If you are unable to agree or object, we may use our professional judgment to determine whether sharing information is in your best interest.
6. Your Rights Regarding Your Health Information
You have the following rights regarding your protected health information.
Right to Get a Copy of Your Medical Record
You have the right to inspect or receive a copy of your medical records and other health information we maintain about you.
We may charge a reasonable, cost-based fee for copies, mailing, or supplies, as permitted by law.
Right to Request Corrections
If you believe information in your medical record is incorrect or incomplete, you may request that we correct or amend it.
We may deny your request in certain circumstances, but we will explain the reason in writing.
Right to Request Confidential Communications
You may ask us to contact you in a specific way, such as only by phone, only by mail, or at a different address.
We will consider reasonable requests and will accommodate requests required by law.
Right to Request Restrictions
You may ask us not to use or disclose certain health information for treatment, payment, or health care operations.
We are not always required to agree to your request, except in certain situations. For example, if you pay for a service in full out of pocket and ask us not to share that information with your health plan, we must agree unless the disclosure is required by law.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures we have made of your health information.
This list will not include all disclosures, such as disclosures made for treatment, payment, health care operations, or disclosures made with your authorization.
Right to Receive a Paper Copy of This Notice
You have the right to receive a paper copy of this Notice at any time, even if you agreed to receive it electronically.
Right to Choose Someone to Act for You
If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights and make choices about your health information, subject to applicable law.
We may verify the person’s authority before taking action.
Right to File a Complaint
You may file a complaint if you believe your privacy rights have been violated.
You may file a complaint directly with Family Tree Medical Group 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.
We will not retaliate against you for filing a complaint.
7. Your Choices
In some situations, you may tell us your preferences regarding what we share. You have the right to tell us whether you want us to share information with:
Family members
Close friends
Caregivers
Others involved in your care
Disaster relief organizations, if applicable
If you are unable to tell us your preference, we may share information if we believe it is in your best interest.
8. Special Protections for Certain Health Information
Certain types of health information may receive additional protections under federal or state law. This may include information related to:
Mental health
HIV/AIDS
Genetic testing
Substance use disorder treatment records
Reproductive health information
Certain minor health services
Communicable diseases
Sexual assault or abuse records
When special protections apply, we will follow the stricter law.
9. Substance Use Disorder Records, If Applicable
If Family Tree Medical Group creates, receives, or maintains substance use disorder treatment records protected by 42 CFR Part 2, those records may receive additional privacy protections.
We will not use or disclose such records except as permitted by applicable law and, when required, with your written consent. Unauthorized redisclosure of specially protected substance use disorder records may be prohibited.
10. Reproductive Health Care Privacy
We will comply with applicable federal and state privacy protections related to reproductive health care information. When required by law, we may take additional steps before disclosing reproductive health care information for certain investigations or proceedings.
11. Breach Notification
We are required to notify you if there is a breach of unsecured protected health information that may have compromised the privacy or security of your information.
12. Our Responsibilities
Family Tree Medical Group is required by law to:
Maintain the privacy and security of your protected health information
Provide this Notice explaining 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 your information
Not use or disclose your information in ways not described in this Notice unless you authorize us in writing
13. Changes to This Notice
We may change the terms of this Notice at any time. Any changes will apply to all health information we maintain, including information created or received before the change.
When we make changes, we will update the effective date and make the revised Notice available on our website and upon request.
14. Contact Information
If you have questions about this Notice, would like a copy, want to exercise your rights, or wish to file a privacy complaint, please contact:
Family Tree Medical Group
Email: admin@familytreemedicalgroup.com
Hunters Creek Area
1150 Cypress Glen Circle
Kissimmee, FL 34741
Phone: 407-483-3200
Fax: 407-483-3220
Davenport
2201 North Blvd. West, Suite B
Davenport, FL 33837
Phone: 863-353-1246
Fax: 863-419-9547
Kissimmee
1050 West Carroll St., Suite B
Kissimmee, FL 34741
Phone: 407-201-3348
Fax: 407-518-0094
You may also file a complaint with:
U.S. Department of Health and Human Services
Office for Civil Rights
Filing a complaint will not affect your care, treatment, or relationship with Family Tree Medical Group.