HIPAA Consent
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Effective Date: October 2, 2026
This Notice of Privacy Practices (“Notice”) explains how your protected health information (“PHI”) may be used and disclosed when you use the telehealth services made available through ridgewellhealth.com, and describes your rights regarding that information. Please read it carefully before continuing.
Federal law, the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), requires covered healthcare providers to protect the privacy of your PHI, to give you notice of their privacy practices, and to follow the terms of the notice currently in effect. This Notice covers PHI created or received in connection with your medical intake, evaluation, and treatment, including information you submit through intake forms and health questionnaires on this site.
PHI means individually identifiable health information relating to your past, present, or future physical or mental health, the healthcare you receive, or payment for that healthcare.
General account information, and activity on this site outside the clinical process (such as browsing behavior or marketing communications), is covered by Ridgewell Health’s Privacy Policy, not this Notice.
Who This Notice Applies To
Three parties are involved in your care, and each has its own responsibilities:
- US Health & Wellness Medical Group (the “Medical Group”) is the covered healthcare entity responsible for clinical care. Its licensed clinicians review your intake information, conduct an appropriate medical evaluation, and determine whether treatment is medically appropriate. Clinicians prescribe, independently of Ridgewell Health LLC and of the pharmacy. The Medical Group is responsible for maintaining the privacy and security of your PHI and for providing this Notice.
- Ridgewell Health LLC operates this website and the online intake platform, processes payments, and provides customer support and administrative services to the Medical Group. Ridgewell Health LLC does not practice medicine, prescribe medication, or dispense medication. Ridgewell Health LLC handles PHI on behalf of the Medical Group only as permitted by law and its agreements with the Medical Group.
- National Health Rx LLC d/b/a Partell Pharmacy is an independent, separately licensed pharmacy that receives your prescription, when a clinician has prescribed treatment, and dispenses and ships your medication under its own privacy and regulatory obligations. Partell Pharmacy is licensed in 49 states (all U.S. states except Texas). We cannot ship to Texas.
Acknowledgment and Consent
By selecting the HIPAA Consent checkbox during intake or checkout, you confirm that you have read this Notice and you consent to the uses and disclosures of your PHI for treatment, payment, and healthcare operations as described below. Completing the intake does not guarantee that a prescription will be written.
How Your Health Information May Be Used and Disclosed
The following uses and disclosures of your PHI may occur without requiring your separate written authorization:
Treatment. To provide and coordinate your care, for example, sharing your intake information with the reviewing clinician, or sending your prescription and related health information to Partell Pharmacy so it can fill the prescription and ship your medication.
Payment. To process payment for your services or, where applicable, prescribed medication, and to provide documentation you may need for insurance reimbursement.
Healthcare Operations. To support quality review, internal audits, and general operation of the telehealth service.
As Required by Law. When disclosure is legally required by a federal, state, or local authority.
Public Health and Safety. For public health reporting, such as adverse-event reporting, or to prevent a serious threat to your health or safety or that of others.
Health Oversight. To a government agency authorized to conduct audits, inspections, or licensure activities.
Legal Proceedings. In response to a court order, subpoena, or other valid legal process.
Law Enforcement. Where required, such as to comply with a court order or report certain categories of injury.
Coroners and Similar Officials. As necessary for a coroner, medical examiner, or funeral director to carry out their duties.
Workers’ Compensation. As necessary to comply with workers’ compensation laws.
Appointment and Treatment-Related Communications. To contact you about your evaluation, follow-up care, or related services.
People Involved in Your Care. To a family member or other person you identify as involved in your care, unless you object.
Business Associates. To vendors, including Ridgewell Health LLC, who perform services on our behalf (such as platform hosting, customer support, or payment processing) and who are contractually required to protect your information.
Uses That Require Your Written Authorization
Other uses and disclosures of your PHI not described above require your separate written authorization, including:
- Use of psychotherapy notes, where applicable
- Use of your PHI for marketing purposes
- Any disclosure that would constitute a sale of your PHI
You may revoke a prior authorization at any time by contacting the Privacy Officer below. Revocation will not undo any disclosures already made in reliance on that authorization.
Your Rights
Access. Request a copy of your PHI records. A reasonable, cost-based fee may apply.
Amendment. Request a correction to PHI you believe is inaccurate or incomplete.
Accounting of Disclosures. Request a list of certain disclosures made of your PHI (this excludes disclosures for treatment, payment, or healthcare operations). The first request in a 12-month period is free.
Request Restrictions. Ask that certain uses or disclosures be limited. We are not always required to agree, except where you have paid out of pocket in full and ask that we not disclose to a health plan.
Confidential Communications. Request that we contact you in a specific way or at a specific location.
Paper Copy. Request a paper copy of this Notice at any time, even if you agreed to receive it electronically.
Breach Notification. Be notified if a breach of your unsecured PHI occurs.
To exercise any of these rights, contact the Privacy Officer below.
Our Responsibilities
The Medical Group is required by law to maintain the privacy and security of your PHI, provide you with this Notice of its legal duties and privacy practices, follow the terms of this Notice, notify you if we cannot accommodate a requested restriction, maintain reasonable safeguards to protect your information, and accommodate reasonable requests for alternative communication. We will notify you following a breach of your unsecured PHI as required by law.
Breach Notification
If a breach of your unsecured PHI occurs, you will be notified without unreasonable delay, and no later than sixty (60) days after discovery, describing what happened, what information was involved, and steps you can take to protect yourself.
Changes to This Notice
We may change the terms of this Notice, and the changes will apply to all PHI we hold. Material changes will be posted here with a new effective date, and we will notify you by email if we have one on file.
Privacy Officer, Questions and Complaints
Questions or complaints about this Notice, or about how your PHI has been handled, can be sent to the Privacy Officer:
Privacy Officer US Health & Wellness Medical Group / Ridgewell Health 706 E Scenic Rivers Blvd, Salem, MO 65560 Phone: (573) 247-1556 Email: support@ridgewellhealth.com.
Website and platform inquiries may also be sent to Ridgewell Health LLC, 706 E Scenic Rivers Blvd, Salem, MO 65560, Phone: (573) 247-1556, Email: support@ridgewellhealth.com.
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by mail (200 Independence Avenue, S.W., Washington, D.C. 20201), by phone (1-877-696-6775), or online at hhs.gov. We will not take any retaliatory action against you for filing a complaint.