NOTICE OF PRIVACY PRACTICES

We understand the importance of privacy and are committed to maintaining the confidentiality of your medical information. We make a record of the medical care we provide and may receive such records from others.We use these records to provide or enable other health care providers to provide quality medicalcare,to obtain payment for services provided to you as allowed by your health plan and to enable us to meet our professional and legal obligations to operate this medical practice properly. We are required by law to maintain the privacy of protected health information, to provide individuals withnoticeofourlegaldutiesandprivacy practiceswithrespect to protected health information, and to notify affected individuals following a breach of unsecuredprotected health information.

If you would like a copy of our full Notice of Privacy Practices, please request this from our front desk.

I HAVE BEEN ADVISED THAT IF I REQUEST A COPY OF THE UPDATED HIPPA POLICY ONE WILL BE FURNISHED TO ME

Patient Name: ___________________________________________________________________________

Patient Signature: _________________________________

Date: ________/_______/________

SMS PRIVACY POLICY

InfiniHealth Medical Group respects the privacy of patients and users who communicate with us by text message (SMS). This SMS Privacy Policy supplements our Notice of Privacy Practices and explains how mobile information and SMS consent are handled.

SMS Communications and Consent

By providing your mobile number and opting in to receive SMS messages from InfiniHealth Medical Group through a web form, patient intake form, verbal consent, or another approved method, you agree to receive text messages related to your care and account.

Messages may include appointment reminders, telemedicine instructions or links, scheduling and rescheduling notices, customer care communications, account notifications, billing reminders, copayment or deductible information, and other patient-responsibility balance notifications.

How We Use and Protect Mobile Information

Mobile phone numbers, SMS opt-in information, and SMS consent data are used only for the purposes described in this policy and to support communications requested or authorized by the patient. InfiniHealth Medical Group does not sell mobile information or SMS consent data.

No mobile information will be shared with third parties or affiliates for marketing or promotional purposes. Text messaging originator opt-in data and consent will not be shared with third parties for their marketing or promotional use.

Information may be disclosed when required by law or to service providers acting on our behalf to deliver or support communications, subject to appropriate privacy and security obligations.

Opt-Out and Assistance

To opt out of SMS messages at any time, reply STOP to any message. For assistance, reply HELP or visit www.infinihealth.org. After an opt-out request, you may receive a final confirmation message.

SMS TERMS & CONDITIONS

By opting into SMS from a web form or other medium, you agree to receive SMS messages from InfiniHealth Medical Group.

Types of Messages

SMS messages may include appointment reminders, telemedicine information or links, scheduling and rescheduling notices, customer care communications, account notifications, billing reminders, copayment or deductible information, and patient-responsibility balance communications.

Message Frequency and Charges

Message frequency may vary. Message and data rates may apply.

Opt-Out

To opt out at any time, text STOP. You may receive a final confirmation message after opting out.

Help

For assistance, text HELP or visit our website at www.infinihealth.org.

Privacy Policy and Terms of Service

Visit www.infinihealth.org for our Privacy Policy and Terms of Service. For SMS registration, if separate website pages are available, use the direct Privacy Policy URL and the direct Terms of Service URL rather than only the home page.

SMS Terms of Service – Registration Language

By opting into SMS from a web form or other medium, you are agreeing to receive SMS messages from InfiniHealth Medical Group. This includes SMS messages for customer care, appointment reminders, telemedicine communications, account notifications, billing reminders, and patient-responsibility balance communications. Message frequency varies. Message and data rates may apply. Message HELP for help. Reply STOP to any message to opt out.