Crest IV Therapy

HIPAA Privacy Policy

Notice of HIPAA Privacy Practices

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.

Effective Date: October 19, 2026

Our Legal Duty & Commitment to Your Privacy

At [Insert Practice / PC Legal Name] ("Practice," "we," "us," or "our"), we are committed to protecting the privacy and security of your Protected Health Information (PHI). We are required by federal law—specifically the Health Insurance Portability and Accountability Act of 1996 (HIPAA)—and state law under the Texas Medical Records Privacy Act (Texas Health & Safety Code Chapter 181) to maintain the privacy of your PHI and to provide you with this Notice of Privacy Practices.

PHI includes any individually identifiable health information created, received, or stored by our practice regarding your past, present, or future physical health, medical conditions, clinical treatments, Good Faith Exams (GFEs), standing orders, or payment for healthcare services.

We are legally required to:

  • Maintain the privacy and security of your PHI.

  • Provide you with this Notice outlining our legal duties and privacy practices.

  • Abide by the terms of the Notice currently in effect.

  • Notify you promptly following any breach of unsecured PHI that may have compromised the privacy or security of your information.

How We May Use & Disclose Your Protected Health Information (PHI)

The following categories describe the different ways we are permitted or required by law to use and disclose your medical information without obtaining your prior written consent or authorization:

1. For Medical Treatment

We use and share your PHI to provide, coordinate, or manage your clinical care.

  • Example: Our treating Registered Nurses (RNs), Medical Director, and mid-level practitioners share your vital signs, health history, and allergy disclosures to safely evaluate, formulate, and administer IV therapies, intramuscular injections, or medical treatments.

  • Example: In compliance with Texas Medical Board (TMB) regulations, we disclose necessary PHI to third-party telehealth practitioners conducting your synchronous Good Faith Exam (GFE) to clear you for treatment and issue Patient-Specific Orders (PSOs).

2. For Healthcare Operations

We use and disclose your PHI to operate our mobile medical practice, evaluate quality of care, train staff, and manage business administration.

  • Example: Conducting internal clinical quality audits, reviewing practitioner documentation accuracy, or engaging external HIPAA-compliant legal, accounting, and technology partners (under signed Business Associate Agreements).

3. For Billing & Payment

We use and disclose PHI to bill and collect payment for the treatments and services provided to you.

  • Example: Transmitting necessary service codes, clinical notes, or payment details to secure PCI-compliant merchant processors (e.g., Stripe) or providing superbills to you for insurance reimbursement requests.

4. Service Location & Mobile Dispatch Communication

Because we operate as a mobile medical provider delivering care to homes, offices, hotels, or event venues, our dispatchers and clinical personnel may use your service address, contact phone number, and scheduled appointment details to coordinate secure, encrypted field visits with our clinical team.

Other Permitted Uses & Disclosures Required or Allowed by Law

We may share your PHI without your authorization in specific situations regulated by federal or state statutes:

  • Public Health & Safety: To report disease outbreaks, adverse drug reactions, product defects, or to prevent a serious, imminent threat to your health/safety or the public.

  • Law Enforcement & Legal Proceedings: Pursuant to a valid court order, administrative subpoena, search warrant, or mandatory judicial process.

  • Health Oversight Activities: To authorized government agencies (e.g., Texas Medical Board, Texas Department of State Health Services, U.S. Department of Health and Human Services) for audits, inspections, or licensure investigations.

  • Organ Donation & Medical Examiners: To coroners, medical examiners, or organ procurement organizations as authorized by law.

  • Workers' Compensation: As necessary to comply with laws relating to workers' compensation or similar legal benefit programs.

Uses & Disclosures Requiring Your Written Authorization

In strict compliance with the Texas Medical Records Privacy Act, any other uses or disclosures of your PHI not described above will be made only with your explicit written authorization. Specifically:

  • Electronic Disclosure & Marketing: We will never sell, rent, or electronically disclose your PHI to third parties for commercial marketing purposes without your explicit written authorization.

  • Clinical Photos/Media: Photos taken during treatment (e.g., IV site assessment or consent documentation) will never be used on social media, websites, or promotional materials without a separate signed Media Release Form.

  • Psychotherapy Notes: If applicable, psychotherapy notes require explicit written authorization.

You may revoke any written authorization at any time in writing, except to the extent that our practice has already taken action based on that authorization.

Your Rights Regarding Your Health Information

Under federal HIPAA regulations and Texas state law, you possess the following rights concerning your PHI:

1. Right to Inspect & Copy Your Medical Records (Texas 15-Business-Day Rule)

You have the right to inspect and obtain an electronic or paper copy of your medical records, clinical charts, and billing history. Requests must be submitted in writing. Under Texas Health & Safety Code § 181.102, we will provide electronic or paper copies of your records no later than the 15th business day after receiving your written request. We may charge a reasonable, cost-based fee for copying, mailing, or transmitting records.

2. Right to Amend Inaccurate Records

If you feel that the PHI we maintain about you is incorrect or incomplete, you may submit a written request asking us to amend the record. We may deny your request under specific statutory conditions (e.g., if the record was not created by us or is determined to be accurate), but we will provide a written explanation within 60 days.

3. Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your PHI for treatment, payment, or healthcare operations. While we will carefully consider all requests, we are not legally required to agree to a requested restriction, except if you request that we not disclose PHI to a health plan for payment or operations purposes and the service has been paid out-of-pocket in full.

4. Right to Confidential & Alternative Communications

You have the right to request that we communicate with you regarding your medical appointments or health matters through specific channels or at alternative locations (e.g., asking us to call a specific mobile number or send correspondence to a P.O. Box).

5. Right to an Accounting of Disclosures

You have the right to request an "accounting of disclosures," which lists certain non-routine disclosures of your PHI made by our practice during the six years prior to your request date (excluding disclosures made for treatment, payment, healthcare operations, or pursuant to your written authorization).

6. Right to a Paper or Electronic Copy of This Notice

You have the right to receive a physical paper copy or electronic copy of this Notice of Privacy Practices at any time, upon request, even if you previously agreed to receive it electronically.

Changes to This Notice of Privacy Practices

We reserve the right to revise or modify the terms of this Notice of Privacy Practices at any time. Any changes will apply to all PHI we maintain, including records created prior to the update. Revised notices will be posted promptly on our website and made available in our online booking portal upon request.

Complaints & Privacy Officer Contact Information

If you believe your privacy rights have been violated, or if you disagree with a decision made about access to your records, you may file a formal complaint with our practice or directly with state and federal regulatory authorities.

  • You will not be penalized or retaliated against in any way for filing a privacy complaint.

To file a privacy complaint or to exercise any of your rights listed in this notice, please contact our Privacy Officer:

  • Email: info@crestivtherapy.com

  • Attn: Privacy Officer

  • Phone: 936-282-5529

  • Mailing Address: 8708 Technology Forest Pl, Suite 175 PMB1063, The Woodlands, TX 77381

State & Federal Regulatory Contacts:

  • Texas Office of the Attorney General (Consumer Protection):

    P.O. Box 12548, Austin, TX 78711 | Phone: (800) 621-0508 | Web: www.texasattorneygeneral.gov

  • Texas Medical Board (TMB):

    P.O. Box 2018, Austin, TX 78768 | Phone: (800) 201-9353 | Web: www.tmb.state.tx.us

  • U.S. Department of Health and Human Services (HHS):

    Office for Civil Rights — Region VI

    1301 Young Street, Suite 1124, Dallas, TX 75202

    Phone: (800) 368-1019 | Web: www.hhs.gov/ocr