Notice of Privacy Practices

Hashimoto’s Hope LLC
525 S. Schmale Rd.
Carol Stream, IL

Website:
https://chicagofunctionalmed.com/functional-medical-website

Privacy Officer:
Dr. Jason Fowler

Effective Date: March 10, 2026

IMPORTANT NOTICE

THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

At Hashimoto’s Hope LLC, we understand that your personal health information is sensitive and private. We are committed to protecting your information while providing functional medicine consultations and thyroid health services.

During your care, we create and maintain records related to your:

• health history

• symptoms

• laboratory testing

• treatment recommendations

• clinical notes

• communication related to your care

These records help us provide quality healthcare services and maintain continuity of care.

We are required by law to:

• maintain the privacy of your Protected Health Information (PHI)

• provide you with this Notice of Privacy Practices

• follow the privacy practices described in this notice

• notify you if a breach of unsecured health information occurs

If you have questions about this notice, please contact our Privacy Officer listed above.

TABLE OF CONTENTS

1. How Hashimoto’s Hope May Use or Disclose Your Health Information

2. When We May Not Use or Disclose Your Health Information

3. Your Health Information Rights

4. Right to Request Special Privacy Protections

5. Right to Request Confidential Communications

6. Right to Inspect and Copy Your Records

7. Right to Amend or Supplement Your Records

8. Right to an Accounting of Disclosures

9. Right to Receive a Copy of This Notice

10. Changes to This Notice of Privacy Practices

11. Complaints

A. How Hashimoto’s Hope May Use or Disclose Your Health Information

Hashimoto’s Hope collects health information about you and stores it in your secure electronic health record system, including our patient portal Practice Better.

The medical record itself is the property of Hashimoto’s Hope LLC, but the health information contained within it belongs to you.

Federal law allows us to use and disclose your health information for the following purposes:

Treatment

We use your health information to provide functional medicine consultations and thyroid health services.

This may include:

• reviewing laboratory results

• evaluating symptoms

•developing personalized treatment plans

• coordinating care with other healthcare providers

• recommending testing or lifestyle interventions

Because our services are provided through telehealth nationwide, this information may be shared electronically through secure healthcare platforms.

We may disclose relevant information to:

• diagnostic laboratories

• pharmacies

• healthcare providers involved in your care

Payment

We may use your health information to obtain payment for services provided.

This may include:

• billing for consultations

• processing payments for functional medicine programs

• processing laboratory testing orders

• documenting services rendered

Healthcare Operations

We may use your information to operate and improve our practice.

Examples include:

• quality improvement

• training and credentialing

• clinical oversight

• compliance reviews

• administrative operations

We may also share your information with business associates who help operate our practice, such as:

• electronic health record providers

• Practice Better

• payment processors

• laboratory companies

• administrative service providers

All business associates are required by law to maintain the privacy and security of your health information.

Telehealth and Electronic Communication

Hashimoto’s Hope provides virtual consultations nationwide through telehealth platforms.

Your health information may be transmitted electronically through secure systems including:

• telehealth video platforms

• Practice Better patient portal

• secure electronic medical records

While we use secure and HIPAA-compliant systems, electronic communication always carries some level of risk.

Appointment Reminders

We may contact you to remind you about:

• upcoming consultations

• follow-up visits

l• aboratory testing

• program participation

These reminders may be sent through:

• email

• text message

• Practice Better patient portal

• telehealth notifications

Communication With Family or Caregivers

With your permission, we may share relevant information with individuals involved in your care, such as family members or caregivers.

Health Education and Wellness Communication

Because Hashimoto’s Hope focuses on thyroid and autoimmune health education, we may contact you with information related to:

• thyroid health education

• lifestyle and nutritional recommendations

• functional medicine testing

• wellness programs

We will not sell your health information or disclose it for marketing purposes without your written authorization.

Required by Law

We may disclose your health information when required by law, including:

• public health reporting

• responding to subpoenas or court orders

• reporting abuse or neglect

• cooperating with law enforcement investigations

B. When Hashimoto’s Hope May Not Use or Disclose Your Health Information

Except as described in this Notice of Privacy Practices, we will not use or disclose your health information without your written authorization.

If you authorize us to use or disclose your information, you may revoke that authorization in writing at any time.

C. Your Health Information Rights

You have several rights regarding your health information.

Right to Request Privacy Restrictions

You may request restrictions on how we use or disclose your health information.

We will review your request and inform you whether we are able to comply.

Right to Request Confidential Communications

You may request that we communicate with you in a specific way.

Examples include:

• sending information to a specific email address

• contacting you only through the patient portal

• sending information to a specific mailing address

Right to Inspect and Copy Your Records

You have the right to review and request copies of your medical records.

Requests must be submitted in writing and may include:

• electronic copies

• printed copies

• records sent to another healthcare provider

Reasonable administrative fees may apply.

Right to Amend Your Records

If you believe information in your medical record is inaccurate or incomplete, you may request an amendment.

Requests must be submitted in writing and include an explanation of the requested change.

Right to an Accounting of Disclosures

You have the right to request a record of certain disclosures of your health information made by Hashimoto’s Hope.

Right to Receive a Copy of This Notice

You have the right to receive a paper or electronic copy of this Notice of Privacy Practices at any time.

Changes to This Notice

Hashimoto’s Hope reserves the right to revise this Notice of Privacy Practices.

If changes are made:

• the updated notice will apply to all health information we maintain

• the updated notice will be posted on our website

• the updated notice will be available through our patient portal

Complaints

If you believe your privacy rights have been violated, you may file a complaint with:

Privacy Officer
Dr. Jason Fowler
Hashimoto’s Hope LLC

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.

Filing a complaint will not affect your care or services