Notice of Privacy Practices

Xcelsior Health, Inc.

3601 W. Azeele St. | Tampa, FL 33609 | 813-605-1977 | support@xcelsiorhealth.com

Privacy Officer: Dr. Ryan Adami

Effective: September 28, 2026

Your Rights

You have the right to inspect or obtain an electronic or paper copy of your medical record and other health information we maintain about you; ask us to correct information you believe is incorrect or incomplete; request reasonable confidential communications; ask us to limit certain uses or disclosures; obtain an accounting of certain disclosures; receive a paper copy of this Notice; and have an authorized person act for you. We may deny certain requests when permitted by law and will explain applicable denials as required.

Restrictions When You Pay in Full

If you pay for a health-care service or item completely out of pocket, you may ask us not to disclose information about that service or item to your health plan for payment or health-care operations. We will honor that request unless disclosure is required by law.

Your Choices

For certain health information, you may tell us your preferences about disclosures to family members, close friends, or others involved in your care or payment for your care, and disclosures in a disaster-relief situation. If you cannot tell us your preference, such as during an emergency, we may disclose information when permitted by law and when we believe it is in your best interest. We may also disclose information when necessary to lessen a serious and imminent threat to health or safety.

Uses Requiring Authorization

We generally will not use or disclose your health information for marketing purposes, sale of your health information, or most uses and disclosures of psychotherapy notes without your written authorization when authorization is required by law. If you authorize a use or disclosure, you may revoke that authorization in writing as permitted by law.

How We Typically Use and Share Your Information

Treatment: We may use your health information and share it with physicians, health-care professionals, laboratories, imaging facilities, pharmacies, specialists, hospitals, and others involved in providing or coordinating your care.

Health-care operations: We may use and disclose your information to operate our practice, improve quality, conduct audits and assessments, perform administrative functions, and manage our services.

Payment: We may use and disclose information as necessary to obtain payment for services, including disclosures to health plans or other entities when applicable.

Business associates: We may disclose protected health information to business associates performing services on our behalf when permitted by HIPAA. They are required to appropriately safeguard protected health information.

Other Uses and Disclosures Permitted or Required by Law

We may use or disclose health information as permitted or required for public-health and safety activities; reporting suspected abuse, neglect, or domestic violence; adverse-event or product-recall activities; health oversight; research when permitted by law; compliance with federal or state law; organ and tissue donation; medical examiner, coroner, or funeral-director activities; workers’ compensation; certain law-enforcement purposes; certain government functions; and court, administrative, or other legal proceedings. We must satisfy applicable legal requirements before making these disclosures.

Substance Use Disorder Records

To the extent Xcelsior Health creates, receives, or maintains substance use disorder patient records protected by 42 CFR Part 2, additional federal confidentiality protections apply. Part 2 records generally may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you unless you provide consent or the use or disclosure is authorized as required by law. If Part 2 information is used for fundraising communications where applicable, appropriate advance notice and an opportunity to opt out will be provided.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information. We will notify you as required by law 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 the Notice currently in effect. We will provide a copy upon request. We will not use or disclose your information other than as described in this Notice unless you authorize us in writing or another use or disclosure is permitted or required by law.

Complaints and Questions

If you believe your privacy rights have been violated, contact Dr. Ryan Adami, Privacy Officer, Xcelsior Health, Inc., 3601 W. Azeele St., Tampa, FL 33609; phone 813-605-1977; email support@xcelsiorhealth.com. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at hhs.gov/hipaa/filing-a-complaint, by calling 1-877-696-6775, or by writing to 200 Independence Avenue, S.W., Washington, D.C. 20201. We will not retaliate against you for filing a complaint.

Changes to This Notice

We may change the terms of this Notice. Changes may apply to all health information we maintain about you, including information created or received before the change. The current Notice will be available upon request at our office and on our website at xcelsiorhealth.com/privacy.