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Notice of Privacy Practices

Sunshine Foot & Ankle LLC Dr. Jonathan Mollineda, DPM Effective Date: July 19, 2026 Supersedes the notice effective April 8, 2026

Important Notice

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION, AND YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Responsibilities

Sunshine Foot & Ankle LLC is required by law to:

  • Maintain the privacy and security of your protected health information;

  • Explain our legal duties and privacy practices in this Notice;

  • Follow the privacy practices described in the Notice currently in effect;

  • Provide you with a copy of this Notice;

  • Notify you when required if a breach may have compromised the privacy or security of your protected health information; and

  • Comply with federal and state laws that provide additional protection for certain health information.

Protected health information, or "PHI," generally means individually identifiable information concerning your health, healthcare, or payment for healthcare.

How We May Use and Disclose Your Health Information

Treatment

We may use your PHI and share it with physicians, hospitals, laboratories, pharmacies, therapists, imaging facilities, home-health providers, medical-equipment suppliers, and other healthcare professionals involved in your care.

For example, we may provide relevant medical information to a specialist to whom we refer you.

Payment

We may use and disclose your PHI to bill and obtain payment for services provided to you. This may include:

  • Verifying insurance eligibility and benefits;

  • Obtaining prior authorization;

  • Submitting claims;

  • Responding to requests from your health plan;

  • Conducting utilization review; and

  • Collecting amounts owed for your care.

Healthcare Operations

We may use and disclose your PHI to operate our practice and improve the quality of care we provide. These activities may include:

  • Quality assessment and improvement;

  • Reviewing provider performance;

  • Staff training;

  • Credentialing and licensing;

  • Compliance and auditing;

  • Business planning;

  • Legal and risk-management activities;

  • Patient-safety activities; and

  • Managing our clinical and administrative systems.

We may also contact you regarding appointments, follow-up care, treatment alternatives, care-management services, health-related benefits, or services that may be relevant to your care.

Business Associates

We may provide PHI to contractors and service providers that perform services for us, including billing, records management, information technology, secure communications, legal, accounting, transcription, and data-storage services.

When required, these business associates must enter into written agreements requiring them to protect PHI and use or disclose it only as permitted by law and their agreements with us.

Your Choices About Certain Disclosures

Family Members, Friends, and Caregivers

Unless you object, we may share PHI that is directly relevant to the involvement of a family member, close friend, caregiver, or another person involved in your care or payment for your care.

We may also share information to help notify someone of your location, general condition, or death.

If you are unable to express a preference, such as during an emergency or when you are unconscious, we may share relevant information when we determine that doing so is in your best interest and is permitted by law.

Disaster-Relief Activities

We may share limited PHI with an authorized disaster-relief organization to help notify family members or others responsible for your care about your location or general condition.

Marketing, Sale of PHI, and Psychotherapy Notes

We will obtain your written authorization before:

  • Using or disclosing PHI for marketing when an authorization is required;

  • Selling your PHI; or

  • Using or disclosing psychotherapy notes when an authorization is required.

We do not sell PHI.

Communications about your treatment, care coordination, treatment alternatives, prescribed products, or health-related services may not legally constitute marketing and may be made without authorization when permitted by law.

Fundraising

We do not currently use PHI to solicit fundraising contributions.

Should our practices change, any fundraising communication will explain how you may opt out of receiving future fundraising communications. If qualifying substance-use-disorder information is involved, we will provide the additional notice and choices required by applicable law.

Written Authorization

Uses and disclosures not described in this Notice will generally be made only with your written authorization.

You may revoke an authorization in writing at any time. Revocation will not affect a use or disclosure already made in reliance on a valid authorization.

Other Uses and Disclosures Permitted or Required by Law

We may use or disclose your PHI in the following circumstances when the applicable legal requirements are satisfied.

Public Health and Safety

We may disclose PHI for authorized public-health and safety activities, including:

  • Preventing or controlling disease;

  • Reporting certain injuries or conditions;

  • Reporting adverse reactions to medications or medical products;

  • Assisting with product recalls;

  • Reporting suspected abuse, neglect, or domestic violence; and

  • Preventing or reducing a serious and imminent threat to health or safety.

Health Oversight

We may disclose PHI to authorized health-oversight agencies for audits, inspections, investigations, licensing activities, disciplinary proceedings, and other activities permitted by law.

Food and Drug Administration

We may disclose PHI to persons or organizations subject to the jurisdiction of the Food and Drug Administration for legally authorized activities involving adverse events, product defects, product tracking, recalls, repairs, replacements, or post-marketing surveillance.

Research

We may use or disclose PHI for research when you authorize the use or when the research has been approved under procedures permitted by law, such as approval by an institutional review board or privacy board.

Abuse, Neglect, or Domestic Violence

We may disclose PHI to an authorized government agency when required or permitted by law to report suspected abuse, neglect, exploitation, or domestic violence.

Organ and Tissue Donation

We may disclose PHI to organ-procurement organizations and other organizations involved in organ, eye, or tissue donation and transplantation.

Coroners, Medical Examiners, and Funeral Directors

We may disclose PHI to a coroner, medical examiner, or funeral director as authorized by law.

Workers' Compensation

We may disclose PHI as authorized by and to the extent necessary to comply with workers' compensation laws and similar programs.

Law Enforcement and Government Functions

We may disclose PHI to law-enforcement officials or government agencies when permitted or required by law and when all applicable conditions have been met.

These disclosures may include certain disclosures:

  • Required by law;

  • Made under an appropriate court order, warrant, subpoena, summons, or administrative request;

  • Used to identify or locate certain individuals;

  • Concerning a victim of a crime;

  • Concerning a death suspected to have resulted from criminal conduct;

  • Concerning criminal conduct occurring on our premises;

  • Needed to report a crime during an emergency; or

  • Required for authorized military, national-security, protective-service, correctional, or custodial purposes.

Legal Proceedings

We may disclose PHI in response to a valid court or administrative order or in response to a subpoena, discovery request, or other lawful process when the requirements of HIPAA, Florida law, and other applicable laws have been satisfied.

Required by Law

We will disclose PHI when federal, state, or local law requires us to do so. This includes disclosures to the U.S. Department of Health and Human Services when it requests information to evaluate our compliance with federal health-privacy requirements.

Substance-Use-Disorder Records

To the extent we create, receive, or maintain substance-use-disorder patient records protected by 42 CFR Part 2, those records receive additional legal protections.

We will not use or disclose qualifying Part 2 records in a civil, criminal, administrative, or legislative investigation or proceeding against you unless:

1. You provide the written consent required by law; or

2. The disclosure is authorized by a court order and subpoena or other legal mandate satisfying the requirements of 42 CFR Part 2.

Part 2 information may be used and redisclosed for treatment, payment, or healthcare operations only as authorized by applicable law and any valid patient consent.

Specially Protected Information

Certain health information may receive additional protection under federal or Florida law, including qualifying:

  • Substance-use-disorder records;

  • HIV testing information;

  • Mental-health or psychotherapy records;

  • Genetic information; and

  • Other specially protected medical information.

We will use and disclose this information only as permitted by the law that applies to the information. When another law provides greater privacy protection than HIPAA, we will follow the more protective law.

Your Rights

Obtain an Electronic or Paper Copy of Your Records

You may ask to inspect or obtain an electronic or paper copy of your medical record and other PHI maintained in a designated record set.

Requests must be submitted in writing using the procedure provided by our office.

We will respond within the time required by law. We may charge a reasonable, cost-based fee permitted by law for providing copies. We will explain any applicable fee in advance when required.

In limited circumstances, we may deny access to all or part of the requested information. When applicable, we will explain the denial in writing and describe any right to have the decision reviewed.

Request an Amendment

You may ask us in writing to amend PHI that you believe is incorrect or incomplete.

We may deny the request for reasons permitted by law. If we deny it, we will provide a written explanation. You may submit a statement of disagreement, and we may prepare a response.

Request Confidential Communications

You may ask us to communicate with you in a particular manner or at an alternative address or telephone number.

For example, you may ask us to call only a particular phone number or send correspondence to a different address. We will accommodate reasonable requests.

Request Restrictions

You may ask us not to use or disclose certain PHI for treatment, payment, or healthcare operations.

We are generally not required to agree to a requested restriction. If we agree, we will comply with the restriction except when the information is needed to provide emergency treatment or when another exception applies.

Services Paid Completely Out of Pocket

When you pay for a healthcare item or service completely out of pocket, you may request that we not disclose information about that item or service to your health plan for payment or healthcare-operations purposes.

We will honor that request unless disclosure is required by law.

You must inform us of the request and complete payment arrangements before the claim or information is submitted to your health plan.

Receive an Accounting of Certain Disclosures

You may request a written accounting of certain disclosures of your PHI made during the six years before the date of your request.

The accounting will not include disclosures that the law excludes from the accounting requirement, such as most disclosures for treatment, payment, and healthcare operations and disclosures you authorized or specifically requested.

We will provide one accounting during any 12-month period without charge. We may charge a reasonable, cost-based fee for an additional accounting requested during the same 12-month period. We will notify you of the fee in advance and give you an opportunity to withdraw or modify the request.

Obtain a Paper Copy of This Notice

You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.

Choose Someone to Act for You

A legally authorized personal representative may exercise your rights and make choices concerning your PHI.

Examples may include a parent or legal guardian of a minor, a court-appointed guardian, or a person with legally sufficient healthcare decision-making authority.

We will verify the person's legal authority before allowing that person to act for you. Certain exceptions may apply when permitted by law.

File a Complaint

You may file a complaint with Sunshine Foot & Ankle LLC if you believe your privacy rights have been violated.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights:

U.S. Department of Health and Human Services Office for Civil Rights 200 Independence Avenue, S.W. Washington, D.C. 20201 Telephone: 1-877-696-6775

Complaints may also be submitted through the HHS Office for Civil Rights online complaint portal.

We will not retaliate against you for filing a complaint, participating in an investigation, or exercising a right described in this Notice.

Changes to This Notice

We may change this Notice and our privacy practices as permitted by law.

A revised Notice may apply to all PHI we maintain, including information created or received before the revision. The current Notice will be available:

  • Upon request;

  • At our office;

  • In a prominent location at the office; and

  • On our website.

Privacy Questions and Complaints

Contact our Privacy Officer for questions, additional information, requests, or complaints:

Sunshine Foot & Ankle LLC — Privacy Officer 2951 NW 49th Avenue, Suite 204 Lauderdale Lakes, Florida 33313 Phone: (754) 296-5900 Email: info@sunshinefootandankle.com

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