Notice of Privacy Practices
Bloom La Vie Health
9787 N Cedar Ave
Kansas City, MO 64157
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.
Bloom La Vie Health (“we,” “us,” or “our practice”) is required by law to maintain the privacy of your protected health information (PHI) and to provide you with this Notice of Privacy Practices. This notice explains how we may use and disclose your medical information, your rights regarding that information, and our legal duties. We are required to abide by the terms of this notice currently in effect.
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an Electronic or Paper Copy of Your Medical Record
- You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask Us to Correct Your Medical Record
- You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
- We may say “no” to your request, but we will tell you why in writing within 60 days.
Request Confidential Communications
- You can ask us to contact you in a specific way (for example, home or cell phone) or to send mail to a different address.
- We will say “yes” to all reasonable requests.
Ask Us to Limit What We Use or Share
- You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it could affect your care. If we agree, we may still share the information if you need emergency treatment.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a List of Those with Whom We’ve Shared Information
- You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
- We will include all disclosures except those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another within 12 months.
Get a Copy of This Privacy Notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with 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, that person can exercise your rights and make choices about your health information.
- We will make sure the person has this authority and can act for you before we take any action.
File a Complaint If You Feel Your Rights Are Violated
- You can complain if you feel we have violated your rights by contacting us using the information at the end of this notice.
- You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
- We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In These Cases, You Have Both the Right and Choice to Tell Us To:
- Share information with your family, close friends, or others involved in your care or payment for your care
- Share information in a disaster relief situation
If you are not able to tell us your preference (for example, if you are unconscious), we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In These Cases We Never Share Your Information Unless You Give Us Written Permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
In the Case of Fundraising
We may contact you for fundraising efforts, but you can tell us not to contact you again. If we have your substance use disorder patient records subject to 42 CFR Part 2, we will give you clear and conspicuous notice in advance and a choice about whether to receive fundraising communications that use your Part 2 information.
Our Uses and Disclosures
How Do We Typically Use or Share Your Health Information?
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 professionals who are treating you.
Example: A physician treating you for a condition may consult with another specialist about your overall health status and laboratory results available in your medical record.
Run Our Organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services, evaluate quality of care, develop clinical protocols, support training, and perform credentialing and medical review activities.
Bill for Your Services
We can use and share your health information to bill and collect payment for the services and items you receive from us. As a Direct Primary Care practice, we primarily bill you directly.
Example: We may use your information to prepare invoices, process membership fees, or address payment-related questions.
How Else Can We Use or Share Your Health Information?
We are allowed or required to share your information in other ways—usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Special Protections for Substance Use Disorder Records: To the extent that we have your substance use disorder patient records subject to 42 CFR Part 2, we will not share that information for investigations or legal proceedings against you without (1) your written consent or (2) a court order and a subpoena. In all cases, if we have substance use disorder patient records about you subject to 42 CFR Part 2, we cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your consent or (2) a court order and a subpoena.
Help with Public Health and Safety Issues
We can 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
Do Research
We can use or share your information for health research under certain conditions required by law.
Comply with the Law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.
Respond to Organ and Tissue Donation Requests
We can share health information about you with organ procurement organizations.
Work with a Medical Examiner or Funeral Director
We can 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 can use or share health information about you:
- For workers’ compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services
Respond to Lawsuits and Legal Actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena, discovery request, or other lawful process.
Additional Uses Specific to Our Practice
Appointment Reminders
We may use your health information to contact you and send appointment reminders by phone, text, email, or mail.
Information About Treatments and Services
We may use your health information to send you information about treatment options, health-related products or services, or other items that we believe may interest you and that relate to your care.
Patient Communications
We may use your name, email address, and/or telephone number to contact you with practice-related communications, such as clinic newsletters, notices of physician absences, or updates regarding services. You may opt out of non-essential communications at any time by contacting our office.
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 give you a copy of it.
- We will not use or share your information other than as described in this notice unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website. Upon request, we will provide you with the most recently revised notice. The revised policies and practices will be applied to all protected health information we maintain.
Complaints and Questions
If you would like to submit a comment or complaint about our privacy practices, or if you believe that your privacy rights have been violated, please contact our Privacy Officer. You will not be penalized or retaliated against for filing a complaint.
Privacy Officer / Practice Administrator
Bloom La Vie Health
9787 N Cedar Ave
Kansas City, MO 64157
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights as described above under “Your Rights.”
Effective Date
This Notice of Privacy Practices is effective on or after August 18, 2026.
