HAZEL HEALTH
JOINT NOTICE OF PRIVACY PRACTICES

Effective Date: February 17, 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.

1. Who Will Follow This Notice and Our Responsibilities

This Notice applies to Telehealth Services USA PC, Telehealth Services Northeast PC, Telehealth Services South PA, Little Sloth Healthcare of Florida, P.A., Little Sloth Healthcare, PC, and Little Sloth Medical, PC, Little Sloth Healthcare of New Jersey, PC (“[Hazel Health Medical Group,” “we,” “our,” or “us”). We are required by law to provide you with this Notice of our legal duties and privacy practices with respect to your Protected Health Information (as defined by HIPAA) (“PHI”), to maintain the privacy of your PHI, and to notify you in the event of a breach of your unsecured PHI. When we use or disclose your PHI, we are required to abide by the terms of this Notice (or other notice in effect at the time of the use or disclosure). 

2. Organized Health Care Arrangement

The covered entities that comprise Hazel Health Medical Group have agreed to participate in an organized health care arrangement (OHCA). An OHCA allows legally separate covered entities to use and disclose protected health information for the joint operation of the arrangement.

The covered entities participating in the Hazel Health OHCA will share protected health information with each other as necessary to carry out treatment, payment, or health care operations relating to the Hazel Health OHCA.

3. Our Uses and Disclosures

We may use and disclose your PHI without your written authorization for the purposes described in this Section. In many cases, we must meet certain conditions before we can share your information for these purposes. Once your PHI has been disclosed as described in this Notice, it may be subject to redisclosure and may no longer be protected by HIPAA.

Some federal and state laws impose special privacy protections for certain health information about you, including mental health information, HIV/AIDS status, and other health information that is given special privacy protection under laws other than HIPAA (“Sensitive Health Information”). We will not share your Sensitive Health Information without your written consent unless a law requires or permits us to share the information. 

If we receive or maintain 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.

• Treatment. We use and disclose your PHI to provide treatment and other services to you. For example, we may use your information to direct or recommend alternative treatments, therapies, health care providers, or settings of care to you or to describe a health-related product or service. We may also disclose PHI to other providers involved in your treatment. 
• Payment. We may use and disclose your PHI to obtain payment for health care services that we provide to you. For example, we may disclose your PHI to claim and obtain payment from Medicare, Medicaid, your health insurer, or another company or program that arranges or pays the cost of your health care. We may also disclose PHI to your other health care providers when such PHI is required for them to receive payment for services they render to you.
• Health Care Operations. We may use and disclose your PHI for our health care operations, which include internal administration and planning and various activities that improve the quality and cost effectiveness of the care that we deliver to you. For example, we may use PHI to evaluate the quality and competence of our providers. We may disclose PHI in order to resolve any complaints you may have and ensure that you are satisfied with our services. In addition, we may use and disclose PHI to develop, test, and validate analytics and artificial intelligence (AI) tools that support clinical decision-making, care coordination, and operational efficiency.
• Business Associates. We may disclose your PHI to our business associates (service providers) who perform services for us, such as data hosting, analytics, quality improvement, and customer support. These parties must protect your information and may use or disclose it only as permitted by our contracts and HIPAA.
• Disclosure to Relatives, Close Friends and Other Caregivers. We may use or disclose your PHI to a family member, other relative, a close personal friend or any other person identified by you when you are present for, or otherwise available prior to, the disclosure, if: (1) we obtain your agreement or provide you with the opportunity to object to the disclosure and you do not object; or (2) we reasonably infer that you do not object to the disclosure. If you are not present for or unavailable prior to a disclosure (e.g., when we receive a telephone call from a family member or other caregiver), we may exercise our professional judgment to determine whether a disclosure is in your best interests. If we disclose information under such circumstances, we would disclose only information that is directly relevant to the person’s involvement with your care. 
• As Required by Law. We may use and disclose your PHI when required to do so by any applicable federal, state or local law.
• Public Health Activities. We may disclose your PHI: (1) to report health information to public health authorities for the purpose of preventing or controlling disease, injury or disability; (2) to report child abuse and neglect to a government authority authorized by law to receive such reports; (3) to report information about products under the jurisdiction of the U.S. Food and Drug Administration; (4) to alert a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition; and (5) to report information to your employer as required under laws addressing work-related illnesses and injuries or workplace medical surveillance. 
• Victims of Abuse, Neglect or Domestic Violence. We may disclose your PHI if we reasonably believe you are a victim of abuse, neglect or domestic violence to a government authority authorized by law to receive reports of such abuse, neglect, or domestic violence. 
• Health Oversight Activities. We may disclose your PHI to an agency that oversees the health care system and is charged with responsibility for ensuring compliance with the rules of government health programs such as Medicare or Medicaid. 
• Judicial and Administrative Proceedings. We may disclose your PHI in the course of a judicial or administrative proceeding in response to a legal order or other lawful process. 
• Law Enforcement Officials. We may disclose your PHI to the police or other law enforcement officials as required by law or in compliance with a court order. 
• Decedents. We may disclose your PHI to a coroner or medical examiner as authorized by law. 
• Organ and Tissue Procurement. We may disclose your PHI to organizations that facilitate organ, eye or tissue procurement, banking or transplantation. 
• Research Activities. We may use and disclose your PHI for research purposes pursuant to a valid authorization from you or when an institutional review board or privacy board has waived the authorization requirement. Under certain circumstances, we may disclose your PHI without your authorization to researchers preparing to conduct a research project, for research on decedents or as part of a data set that omits your name and other information that can directly identify you.
• Health or Safety. We may use or disclose your PHI to prevent or lessen a serious and imminent threat to a person’s or the public’s health or safety. 
• Specialized Government Functions. We may use and disclose your PHI to units of the government with special functions, such as the U.S. military or the U.S. Department of State under certain circumstances. 
• Workers’ Compensation. We may disclose your PHI as authorized by and to the extent necessary to comply with state law relating to workers’ compensation or other similar programs.

4. Your Choices

You have choices regarding uses and disclosures of your PHI not described in Section 2. We will only make such uses and disclosures with your authorization, including: 

• Marketing. We must obtain your written authorization prior to using your PHI for purposes that are marketing under the HIPAA privacy rules. For example, we will not accept any payments from other organizations or individuals in exchange for making communications to you about treatments, therapies, health care providers, settings of care, case management, care coordination, products or services unless you have given us your authorization to do so or the communication is permitted by law. However, we may provide refill reminders or communicate with you about a drug or biologic that is currently prescribed to you so long as any payment we receive for making the communication is reasonably related to our cost of making the communication. In addition, we may market to you in a face-to-face encounter and give you promotional gifts of nominal value without obtaining your written authorization. 

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• Sale of PHI. We will not make any disclosure of PHI that is a sale of PHI without your written authorization.

If you provide your authorization, you may later revoke it by delivering a written revocation statement to our Privacy Officer using the contact information at the end of this Notice. Your revocation will take effect when we receive it, but it will not affect any action we took in reliance on your authorization prior to revocation.

5. Your Rights

You have certain rights regarding your PHI. This section explains your rights and some of our responsibilities to help you.

• Right to Access Records. In accordance with the Health Insurance Portability and Accountability Act (HIPAA) and other applicable federal and state privacy laws, patients and their legal guardians have the right to inspect and receive a copy of their protected health information and medical records. We are committed to honoring these rights and will provide the requested records within 30 days of receiving a valid request.
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HOW TO REQUEST RECORDS:

If you are a patient, legal guardian, or third party / authorized representative and would like to obtain a copy of medical records, please follow these steps:
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1. Obtain the ROI Form. Please download our 2026 Hazel Health Third Party Release of Information form. 

2. Complete the form. To ensure a timely response, please sign and complete all fields indicated within the form. 

3. Submit via Email. Send your fully completed and signed form to our Medical Records Department at medicalrecords@hazel.co.

Verification Notice: To protect patient privacy, we may require additional documentation to verify your identity or legal guardianship before records are released. For example, a photocopy of your government ID or company badge identification.
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• Right to Amend Records. You can ask us to correct PHI about you that you think is incorrect or incomplete. We may say “no” to your request, but we’ll tell you why in writing within  60 days. Contact our Privacy Officer to make a request.

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• Right to Request Confidential Communications. You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.

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• Right to Request Restrictions. You can ask us not to use or share certain PHI for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. However, 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.

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• Right to Receive an Accounting of Disclosures. You can ask for a list (accounting) of the times we’ve shared your PHI in the six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

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• Right to Receive a Paper Copy of this 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.

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• Right to File a Complaint. You can complain if you feel we have violated your rights by contacting us using the contact information at the end of this Notice. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter. You can request the correct address for the Office for Civil Rights from our Privacy Officer. We will not retaliate against you for filing a complaint.

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6. Changes to 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.

7. Contact Us

You may contact us at:

Hazel Health Medical Group

Attn: Privacy Officer

8300 Esters Blvd Ste 900, Irving, Texas, 75063

privacy@hazel.co

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