Last Updated: September 12, 2026

THIS NOTICE DETAILS HOW MEDICAL INFORMATION REGARDING YOU MAY BE UTILIZED AND/OR DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW THIS INFORMATION CAREFULLY.

1. Entities in this notice

This notice details the practices of Ivy Skin Studio (“we,” “us,” or “our”) and the practices that will be followed by all of Ivy Skin Studio workforce members who handle your medical information.

2. Your Protected Health Information (PHI)

Ivy Skin Studio understands that medical information about you is personal and we are committed to protecting it. We maintain records and conduct treatments with the goal of providing the highest level of protection for your medical information, while still providing you with the highest level of medical care. This notices applies to all records of your medical care that are received or created by Ivy Skin Studio.

Other medical providers (e.g., doctors, hospitals, home health agencies, etc.) may have different policies or notices regarding the use and disclosure of your medical information. Those statements, policies, and guidelines do not apply to the policy provided in this notice.

This notice outlines the ways in which Ivy Skin Studio may use and disclose medical information about you. Your medical information, also referred to as “protected health information,” includes your demographic information or any other information that may identify you and relates to your past, present, or future physical or mental health information and related health care services.

In this notice, we also describe your rights and certain obligations Ivy Skin Studio has regarding the use and disclosure of your PHI. We are required to:

1. Ensure that medical and other information identifying you (PHI) is kept private.

2. Provide you this notice of our legal duties and privacy practices with respect to PHI about you.

3. Follow the terms of the notice currently in effect.

3. Uses and disclosures for treatment, payment, and health care operations

By becoming a patient at Ivy Skin Studio, you are giving consent for Ivy Skin Studio to use your PHI for certain activities, including treatment, payment, and other health care operations.

Your PHI may be disclosed by Ivy Skin Studio so that Ivy Skin Studio and its medical professionals can provide treatment to you, including, but not limited to:

• Using your past medical information in order to diagnose your present condition

• Ivy Skin Studio may provide information regarding your medical condition to another doctor to whom Ivy Skin Studio refers you to for additional care.

• Ivy Skin Studio may also use and disclose PHI regarding you so that Ivy Skin Studio may be paid for the medical treatment we provide you.

• Ivy Skin Studio may also use and disclose PHI regarding you for our health care operations, including to evaluate how we can better meet your needs.

• Ivy Skin Studio may provide PHI regarding you to an auditor who reviews books/files so that Ivy Skin Studio may keep current licensing to provide medical services.

4. Other uses and disclosures of your protected health information

The following uses of your protected health information may be made without any additional authorization from you. (Not every use or disclosure is listed, but be assured that all uses and disclosures made by Ivy Skin Studio are only those which are permitted under the law).

Uses and disclosures for appointment reminders

We may use and disclose your medical information to contact you as a reminder that you have an appointment at the office. If you request that such communications be made confidentially, please contact our office in writing at 1400 Liberty Pike, Suite 1000, Franklin, TN 37064. We will accommodate all reasonable requests.

Uses and disclosures to others involved in your healthcare

We may disclose your PHI to any person that you identify (e.g., a family member, close friend, etc.) that directly relates to their involvement in your medical care. In the event you are unable to agree or object to this disclosure, we may disclose such information as necessary if we determine that it is in your best interests based on our professional judgment.

Your PHI may also be used or disclosed by us to notify or assist in notifying a family member, personal representative, or any other person responsible for your care of your location, general condition, or death.

Lastly, your PHI may be used or disclosed by us to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.

Uses and disclosures in emergency situations

We may use or disclose your PHI in an emergency treatment situation. If this happens, we will attempt to obtain your acknowledgment of this Notice as soon as reasonably practicable after the delivery of treatment.

Uses and disclosures for health-related benefits or services

From time to time, Ivy Skin Studio may use and disclose PHI to tell you about certain health-related benefits or services that may be of interest to you.

Uses and disclosures required by law

We will use or disclose PHI about you when required to do so by federal, state, or local law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, if the law requires or allows us to do so, of any such uses or disclosures. We must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the law.

Uses and disclosures related to communicable diseases

We may disclose your PHI, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

Disclosures for health oversight activities

We may disclose your PHI to a health oversight agency for activities authorized by law. These activities include, for example, audits, investigations, and inspections. These activities are necessary for the government to monitor the health care system, the delivery of health care, government benefit programs, other government regulatory programs, and civil rights laws.

Disclosures of abuse or neglect

We may disclose your PHI to a public health authority authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your PHI if we believe that you have been a victim of abuse, neglect, or domestic violence to a governmental entity or agency authorized to receive such information. In such cases, the disclosure will only be made in accordance with law.

Disclosures to the Food and Drug Administration

We may disclose your PHI to a person or company required by the Food and Drug Administration (FDA) to report adverse events, product defects, or other problems; biologic product deviations; to track products; to enable product recalls; to make repairs or replacements; or to conduct post-market surveillance, as required.

Disclosures for lawsuits and disputes

If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court order or administrative order. We may also disclose your PHI in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Disclosures to law enforcement

We may disclose your PHI if required to do so by a law enforcement official, in response to a court order, subpoena, warrant, summons, or similar process.

Other related disclosures may include those relating to individuals who are Armed Forces personnel, to national security and intelligence agencies, as well as disclosures to authorized federal officials for the protection of the President of the United States or other authorized persons or foreign heads of state.

Disclosures to coroners, funeral directors, and organ donation

We may disclose your PHI to a coroner or medical examiner for identification purposes, determining cause of death, or for the coroner or medical examiner to perform other duties required by law. We may also disclose your PHI to a funeral director in order to permit the funeral director to carry out legal duties, and may do so if death is reasonably anticipated. Your PHI may also be disclosed for certain organ donations to which you may have agreed.

Disclosures for research

We may disclose your PHI to researchers when their research has been approved and protocols have been established to ensure the privacy of your information. We may also disclose a limited set of your information, as allowed under the law, for research purposes.

Disclosures related to criminal activity

We may disclose your PHI, consistent with federal, state, or local laws, if we believe that the use or disclosure is necessary to prevent or lessen a serious or imminent threat to the health or safety of a person or the public, or if it is necessary for law enforcement authorities to identify or apprehend an individual.

Disclosures for Workers’ Compensation

We may disclose your PHI for Workers’ Compensation or similar programs, consistent with federal, state, or local laws. These programs provide benefits for work-related injuries or illnesses.

5. Your rights regarding PHI about you

Right to inspect and copy

You have the right to inspect and copy PHI that may be used to make decisions about your medical care. Usually this right includes both medical and billing records. You must submit your request in writing. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. Your request to inspect and copy your information may only be denied in very limited circumstances and you have a right to request that any such denial be reviewed.

Right to request restrictions

You have the right to request that we restrict the use and disclosure of your PHI for treatment, payment, and health care operations. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment or comply with federal, state, or local laws.

To request restrictions, you must make your request in writing to 1400 Liberty Pike, Suite 1000, Franklin, TN 37064. In your request, you must tell us:

• What information you want to limit.

• Whether you want to limit our use, disclosure, or both.

• To whom you want the limits to apply.

Right to confidential communications

You also have the right to request to receive private health information communications (such as appointment confirmations) by alternative means or at alternative locations. For example, you can ask that we only contact you at work or by physical mail. To request confidential communications, you must make your request in writing to 1400 Liberty Pike, Suite 1000, Franklin, TN 37064. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to amend

If you feel that the PHI we have about you is incorrect or incomplete, you have the right to request that your PHI be amended. Only the health care entity (e.g., doctor, hospital, clinic, etc.) that created your PHI is responsible for amending it. For more information regarding the procedures for submitting such a request, contact us in writing at 1400 Liberty Pike, Suite 1000, Franklin, TN 37064.

Right to an accounting of disclosures

You have a right to an accounting of disclosures of your PHI, for purposes other than treatment, payment, or health care operations by Ivy Skin Studio or any of the people or companies who perform treatment, payment, or health care operations on our behalf. To request this list of disclosures we may have made of PHI about you, you must submit a request in writing to 1400 Liberty Pike, Suite 1000, Franklin, TN 37064. Your request must state a time period which may not be longer than six (6) years prior to the date of your request and may not include dates before August 1, 2005. Your request should indicate the form in which you want the list (e.g., on paper or electronically). You will be charged for photocopying.

Right to a paper copy of this notice

You have the right to a paper copy of this Notice. You may ask us to give you a copy of this notice at any time by contacting us at privacy@ivyskinstudio.com or by phone at 615-471-8525.

You may obtain a copy of this Notice at our website: www.ivyskinstudio.com.

To learn more about these procedures, or to make any of these requests, you may contact us at privacy@ivyskinstudio.com.

6. Changes to this notice

Ivy Skin Studio reserves the right to change this Notice. We reserve the right to make the revised or changed Notice effective for PHI we already have about you, as well as any information we create or receive in the future. We will post a copy of the current Notice on our website: www.ivyskinstudio.com. The Notice will contain, in the top right-hand corner, the effective date.

7. Complaints

If you believe your privacy rights have been violated and/or that Ivy Skin Studio has not followed this policy, you may file a complaint with our Office Manager or with the Secretary of the Department of Health and Human Services.

To file a complaint with our Office Manager, contact us in writing at 1400 Liberty Pike, Suite 1000, Franklin, TN 37064. You will not be penalized for filing a complaint.

8. Other uses of protected health information

Other uses and disclosures of your PHI not covered by this notice or the laws that apply to Ivy Skin Studio will be made only with your written permission (“authorization”). If you provide us permission to use or disclose your PHI, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose your PHI for the reasons covered by your authorization. You understand that we are unable to take back any disclosures we may have already made with your permission, and that we are required to retain our records of the medical treatment or other services that we have provided to you.

9. Questions?

If you have any questions regarding this notice, please contact us at privacy@ivyskinstudio.com or by phone at 615-471-8525.