HIPAA Privacy Policy Statement
This HIPAA Privacy Policy Statement applies to Broad St. Weight Management Center, Inc. and Premier Physicians Weight Loss Center, Inc. under the medical direction of Dr. Robert Fortino, D.O., and outlines our commitment to protecting the privacy and security of our patients’ protected health information (PHI) in compliance with the Health Insurance Portability and Accountability Act (HIPAA).

 

Collection of Your Health Information
We may collect the following types of personally identifiable health information:

• Name, address, telephone number, and email address
• Date of birth, gender, and other demographic details
• Medical history, diagnosis, treatment, and health insurance information
• Billing and payment information, including credit card data for purchases
• Communications and interactions via email, online forms, or the website

 

Use and Disclosure of Health Information
Your protected health information may be used and disclosed for the following purposes:

• Treatment: To provide, coordinate, or manage your healthcare services
• Payment: To obtain reimbursement from your insurance provider or you directly
• Healthcare Operations: For internal operations such as quality assessment, training, and auditing
• Legal Requirements: When required by law or in response to legal processes
• Public Health Activities: To report health conditions as required by public health authorities

 

Your Rights Under HIPAA
You have the following rights regarding your protected health information:

• Right to Access: You may request access to your medical records
• Right to Amend: You may request correction of inaccurate or incomplete information
• Right to an Accounting: You can request a list of disclosures of your PHI
• Right to Request Restrictions: You may ask us to restrict certain uses and disclosures
• Right to Confidential Communications: You can request communications via alternative means
• Right to a Copy of This Notice: You can request a paper or digital copy at any time

 

Safeguarding Your Information
We implement appropriate administrative, technical, and physical safeguards to protect your PHI against unauthorized access, use, or disclosure. This includes the use of secure servers, encryption, access control, and employee training.

 

Breach Notification
In the event of a breach of your unsecured protected health information, you will be notified in accordance with federal regulations.

 

Changes to This Policy
We reserve the right to change this HIPAA Privacy Policy at any time. Updates will be posted on our website and can be requested in writing.

 

Contact Information
If you have any questions about this HIPAA Privacy Policy or believe your privacy rights have been violated, please contact us at:

Robert Fortino, D.O.
Broad St. Weight Management Center, Inc. and Premier Physicians Weight Loss Center, Inc.
Website: www.drfortino.net

Effective Date: June 18, 2025