Momentum Health & Wellness Institute
Effective Date: February 16, 2026
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.
Momentum Health & Wellness Institute is required by law to protect the privacy of your Protected Health Information (PHI), provide you with this Notice of our legal duties and privacy practices, and follow the terms currently in effect.
We may use your health information to provide, coordinate, or manage your healthcare and related services.
We may use your health information to bill and receive payment for the services we provide.
We may use your health information to support clinic operations, including quality assessment, staff training, licensing, and administrative activities.
We may disclose your health information when required or permitted by law, including public health reporting, health oversight activities, legal proceedings, law enforcement purposes, and preventing serious threats to health or safety.
Other uses and disclosures not described in this Notice will only be made with your written authorization. You may revoke your authorization at any time in writing.
We comply with applicable federal regulations under 42 CFR Part 2, which provide additional privacy protections for Substance Use Disorder records. These records will not be disclosed without your written consent except where permitted by law.
You have the right to access and obtain a copy of your medical records.
You have the right to request corrections to your medical records.
You have the right to request restrictions on certain uses and disclosures.
You have the right to request confidential communications.
You have the right to receive a copy of this Notice.
We are required by law to maintain the privacy and security of your Protected Health Information.
We are required to provide you with this Notice of our legal duties and privacy practices.
We are required to notify you in the event of a breach involving your health information.
We are required to follow the terms of this Notice currently in effect.
If you believe your privacy rights have been violated, you may file a complaint with our clinic or with the U.S. Department of Health and Human Services.
You will not be penalized for filing a complaint.
Momentum Health & Wellness Institute
Email: [email protected]
Phone: (657) 275-9092
You may also file a complaint with:
U.S. Department of Health and Human Services
Office for Civil Rights
https://www.hhs.gov/ocr/privacy/hipaa/complaints/
We reserve the right to update this Notice at any time. Any changes will be posted on our website.
Momentum Health & Wellness Institute
Email: [email protected]
Phone: (657) 275-9092
