NOTICE OF PRIVACY PRACTICES

Naturally Balanced Health and Wellness LLC
d/b/a Mindfully Balanced Health

Effective Date: August 9, 2026

Privacy Contact:
Camille McCarley, FNP
18610 E Rittenhouse Rd, Bldg A, Suite 100
Queen Creek, AZ 85142
480-788-2422
info@mindfullybalancedhealth.com

Your Information. Your Rights. Our Responsibilities.

This notice explains how your medical information may be used and disclosed, how you can access your information, and the privacy rights available to you. Please review it carefully.

Your Rights

You have rights regarding your health information, including the right to:

  • Obtain an electronic or paper copy of your medical record.

  • Ask us to correct information in your medical record.

  • Request that we communicate with you confidentially in a particular way or at a particular location.

  • Ask us to limit certain uses or disclosures of your information.

  • Request an accounting of certain disclosures of your health information.

  • Obtain a paper copy of this Notice of Privacy Practices.

  • Designate an authorized person to act on your behalf.

  • File a complaint if you believe your privacy rights have been violated.

Your Choices

For certain health information, you can tell us your preferences about what we share. If you have a clear preference about how we share your information in the situations described below, please let us know. We will follow your instructions when required by law.

You may tell us whether you want us to:

  • Share information with your family, close friends, or others involved in your care.

  • Share information in a disaster relief situation.

  • Include your information in a hospital or facility directory, if applicable.

If you are unable to tell us your preference—for example, if you are unconscious—we may share your information when we believe it is in your best interest and permitted by law. We may also share information when necessary to reduce a serious and imminent threat to health or safety.

Marketing and Sale of Your Information

We will not use or share your health information for marketing purposes or sell your health information without your written authorization when authorization is required by law.

Fundraising

If we contact you for fundraising purposes, you have the right to tell us not to contact you again.

Our Uses and Disclosures

We typically use or share your health information in the following ways:

Treat You

We can use your health information and share it with other healthcare professionals who are treating you.

Example: We may share information about your health with a specialist, pharmacy, laboratory, or other healthcare provider involved in your care.

Run Our Practice

We can use and share your health information to operate our practice, improve your care, and contact you when necessary.

Example: We may use health information to review the quality of care and services we provide.

Bill for Your Services

We can use and share your health information to bill and obtain payment from health plans or other entities.

Example: We may provide information about your care to your health insurance company so it will pay for covered services.

How Else Can We Use or Share Your Health Information?

We are allowed or required to share your information in other ways, usually for purposes that contribute to the public good, such as public health and research. We must meet applicable legal requirements before sharing your information for these purposes.

Help With Public Health and Safety Issues

We may share health information about you for certain situations, such as:

  • Preventing disease.

  • Helping with product recalls.

  • Reporting adverse reactions to medications.

  • Reporting suspected abuse, neglect, or domestic violence.

  • Preventing or reducing a serious threat to anyone's health or safety.

Conduct Research

We may use or share your information for health research when permitted by law and when applicable requirements are met.

Comply With the Law

We will share information about you when state or federal law requires us to do so.

Respond to Organ and Tissue Donation Requests

We may share health information with organ procurement organizations when applicable.

Work With a Medical Examiner or Funeral Director

We may share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address Workers' Compensation, Law Enforcement, and Other Government Requests

We may use or share health information about you:

  • For workers' compensation claims.

  • For certain law enforcement purposes or with law enforcement officials.

  • With health oversight agencies for activities authorized by law.

  • For certain special government functions, such as military, national security, and presidential protective services.

Respond to Lawsuits and Legal Actions

We may share health information about you in response to a court or administrative order or in response to a subpoena when the applicable legal requirements have been met.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.

We will let you know 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 with a copy of it.

We will not use or share your information other than as described in this Notice unless you give us written authorization. If you give us written authorization, you may change your mind at any time by notifying us in writing.

Changes to the Terms of This Notice

We may change the terms of this Notice, and the changes may apply to all information we have about you.

If we make changes, the updated Notice will be available upon request, at our office, and on our website.

Questions or Complaints

If you have questions about this Notice or believe your privacy rights have been violated, you may contact:

Camille McCarley, FNP
Privacy Contact
Naturally Balanced Health and Wellness LLC
d/b/a Mindfully Balanced Health
18610 E Rittenhouse Rd, Bldg A, Suite 100
Queen Creek, AZ 85142
Phone: 480-788-2422
Email: info@mindfullybalancedhealth.com

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.

Your Rights in Detail

When it comes to your health information, you have certain rights. This section explains those rights and our responsibilities to help you exercise them.

Get an Electronic or Paper Copy of Your Medical Record

You may ask to see or receive an electronic or paper copy of your medical record and other health information we maintain about you. Contact us to learn how to make this request.

We will generally provide a copy or summary of your health information within 30 days of your request. We may charge a reasonable, cost-based fee as permitted by law.

Ask Us to Correct Your Medical Record

You may ask us to correct health information about you that you believe is incorrect or incomplete.

We may deny your request in certain circumstances. If we do, we will explain the reason to you in writing, generally within 60 days.

Request Confidential Communications

You may ask us to contact you in a specific way, such as at your home, office, or cell phone, or ask us to send mail to a different address.

We will accommodate reasonable requests.

Ask Us to Limit What We Use or Share

You may ask us not to use or share certain health information for treatment, payment, or healthcare operations. We are generally not required to agree to your request. If we agree, we may still disclose the information if it is necessary to provide emergency treatment.

If you pay for a healthcare service or item completely out of pocket, you may ask us not to share information about that service or item with your health insurer for payment or healthcare operations purposes. We will honor that request unless the law requires us to disclose the information.

Get a List of Certain Disclosures

You may request an accounting of certain disclosures of your health information made during the six years before the date of your request. The accounting will generally identify when the information was shared, with whom, and why.

Certain disclosures are not included, such as disclosures for treatment, payment, and healthcare operations and certain disclosures you specifically requested.

We will provide one accounting during any 12-month period at no charge. We may charge a reasonable, cost-based fee for additional requests during the same 12-month period.

Get a 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. We will provide a paper copy promptly.

Choose Someone to Act for You

If you have given someone medical power of attorney or if someone is your legal guardian or otherwise legally authorized to act as your personal representative, that person may exercise your privacy rights and make choices regarding your health information.

We will verify that the person has appropriate authority before taking action on your behalf.

File a Complaint if You Believe Your Rights Have Been Violated

If you believe your privacy rights have been violated, you may contact:

Camille McCarley, FNP
Privacy Contact
Naturally Balanced Health and Wellness LLC
d/b/a Mindfully Balanced Health
18610 E Rittenhouse Rd, Bldg A, Suite 100
Queen Creek, AZ 85142
480-788-2422
info@mindfullybalancedhealth.com

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.

Additional Privacy Protections

Additional Protections Under State and Federal Law

Some types of health information may receive additional privacy protections under Arizona or federal law. When a law provides greater protection for your health information than the protections described in this Notice, we will follow the more protective law.

This may include certain information related to:

  • Communicable diseases and HIV-related information.

  • Genetic testing and genetic information.

  • Mental and behavioral health information.

  • Other categories of health information that receive special protection under applicable state or federal law.

We will obtain your authorization before using or disclosing specially protected health information when authorization is required by applicable law.

Medical Record Retention

We maintain medical records in accordance with applicable Arizona and federal law.