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Legal

HIPAA Notice of Privacy Practices

Celly Mobile Dialysis, Inc. — Covered Entity / Business Associate

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.

Table of Contents

Your Rights Typical Uses of Your Info Your Choices Other Uses & Disclosures Our Responsibilities Changes to This Notice
Patient Rights

When It Comes to Your Health Information, You Have Certain Rights

Get a 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. We will provide a copy or 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'll tell you why in writing within 60 days.

Request Confidential Communications

You can ask us to contact you in a specific way (for example, by phone or mail to a specific address). We will accommodate 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 if it would affect your care.

If you pay for a dialysis service out-of-pocket in full, you can ask us not to share that information with your health insurer for payment or operations purposes. We will honor this unless a law requires us to share it.

Get a List of Those With Whom We've Shared Information

You can request an accounting of disclosures of your health information for the six years prior to the date of your request. We'll provide one accounting per year at no charge; a reasonable fee may apply for additional requests within 12 months.

Get a Copy of This Notice

You can request a paper copy of this notice at any time, even if you have received it electronically. We will provide it promptly.

Choose Someone to Act for You

If you have granted medical power of attorney or have a legal guardian, that person may exercise your rights and make choices about your health information. We will verify authority before taking action.

File a Complaint

If you believe we have violated your HIPAA rights, you may file a complaint with us using the contact information at the bottom of this page.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights: 200 Independence Avenue, S.W., Washington, D.C. 20201 — call 1-877-696-6775, or visit www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

Choices

You Have Choices in the Way We Use and Share Information

For certain health information, you can tell us your preferences. If you have a clear preference for how we share your information in the situations below, let us know and we will follow your instructions.

You Have the Right and Choice to Tell Us To:

Share information with your family, close friends, or others involved in 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 share your information if we believe it is in your best interest, or when needed to address a serious and imminent threat to health or safety.
We Never Share Your Information Without Written Permission For:

Marketing purposes

Sale of your information

Typical Uses

How Do We Typically Use or Share Your Health Information?

Treat You
We share your health information with the physicians, nurses, and clinical staff involved in your dialysis or apheresis care. Example: Our nurse shares your treatment parameters with your attending nephrologist.
Run Our Organization
We use health information to manage treatment delivery, quality assurance, and care coordination. Example: We review treatment records to ensure clinical standards are met.
Bill for Services
We share information needed to bill the facility partner or applicable insurer for services rendered. Example: We provide treatment records to support billing for a course of acute hemodialysis.
Other Uses

How Else Can We Use or Share Your Health Information?

We may share your information in other ways permitted or required by law, generally for public good purposes. We must meet legal conditions before sharing for these purposes.

Public Health & Safety
Preventing disease, reporting adverse events, reporting suspected abuse or neglect, or reducing a serious and imminent threat to health or safety.
Research
We may use or share de-identified information for healthcare research purposes, subject to applicable law.
Comply with the Law
We share information when required by state or federal law, including with the Department of Health and Human Services.
Medical Examiner / Funeral Director
We may share health information with a coroner, medical examiner, or funeral director when an individual dies.
Workers' Comp & Government
For workers' compensation claims, law enforcement, health oversight agencies, and special government functions.
Lawsuits & Legal Actions
We may share information in response to a court order, administrative order, or valid legal subpoena.

For more information: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/

Responsibilities

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.
We will notify you 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 provide you a copy upon request.
We will not use or share your information other than as described here unless you authorize it in writing. You may withdraw that authorization at any time in writing.

For more information: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

Changes

Changes to This Notice

We may change the terms of this notice at any time. Changes will apply to all health information we hold about you. The updated notice will be available on our website and upon request.

Questions About This Notice?

Email: info@cellymobiledialysis.com

Phone: 1-407-324-4023

Mail: Celly Mobile Dialysis, Inc., Attn: Legal, 582 Monroe Rd Suite 1424, Sanford, FL 32771

Celly Mobile Dialysis, Inc. — Covered Entity / Business Associate. © 2026 Celly Mobile Dialysis, Inc. All rights reserved.