Notice of Privacy Practices

About this notice

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.

The National Robotic Spine Institute ("NRSI," "we," "us") is required by law to maintain the privacy of your protected health information, to give you this notice of our legal duties and privacy practices, and to notify you if a breach affects your unsecured health information. We must follow the terms of the notice currently in effect.

How we use and share your information

We typically use or share your health information in the following ways without your written permission:

• Treatment. We use your information and share it with other professionals who are treating you, such as your primary care doctor, a hospital or a physical therapist.
• Payment. We use and share your information to bill and get payment from health plans or other entities.
• Health care operations. We use and share your information to run our practice, improve your care and contact you when necessary, such as for appointment reminders.
• Business associates. We may share your information with companies that perform services for us, such as billing or IT services. They must sign an agreement to protect it.

Other uses and disclosures

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good. We have to meet many conditions in the law before we can share your information for these purposes:

• Public health and safety, such as reporting disease, product recalls, adverse reactions to medications, or suspected abuse or neglect, and preventing a serious threat to anyone's health or safety.
• Health oversight activities authorized by law, such as audits and inspections.
• Research that meets legal requirements for privacy protection.
• When required by state or federal law, including to the Department of Health and Human Services.
• Organ and tissue donation requests, and medical examiners or funeral directors.
• Workers' compensation claims, law enforcement purposes, and special government functions such as military or national security.
• Responding to a court or administrative order, or to a subpoena.

Your choices

For certain information, you can tell us your choices about what we share. You have both the right and choice to tell us to share information with your family, close friends or others involved in your care, or in a disaster relief situation. If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest.

In these cases we never share your information unless you give us written permission: marketing purposes, sale of your information, and most sharing of psychotherapy notes. Other uses not described in this notice will be made only with your written authorization, which you may revoke in writing at any time.

Your rights

• Get a copy of your medical record. You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or a summary, usually within 30 days of your request, and may charge a reasonable, cost-based fee.
• Ask us to correct your record. You can ask us to correct health information that you think is incorrect or incomplete. We may say no, but we will tell you why in writing within 60 days.
• Request confidential communications. You can ask us to contact you in a specific way, such as a home or office phone, or to send mail to a different address. We will say yes to all reasonable requests.
• Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment or our operations. We are not required to agree. If you pay for a service or item out of pocket in full, you can ask us not to share that information with your health insurer, and we will say yes unless a law requires us to share it.
• Get a list of those we have shared information with. You can ask for a list of the times we have shared your information for six years prior to the date you ask, who we shared it with and why. This excludes disclosures for treatment, payment, health care operations and certain others.
• Get a copy of this notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive it electronically.
• Choose someone to act for you. If you have given someone medical power of attorney, or someone is your legal guardian, that person can exercise your rights and make choices about your health information.

Complaints

If you believe your privacy rights have been violated, you can file a complaint with us using the contact information below, or with the U.S. Department of Health and Human Services Office for Civil Rights by visiting hhs.gov/ocr/complaints, calling 1-877-696-6775, or writing to 200 Independence Avenue S.W., Washington, D.C. 20201.

We will not retaliate against you for filing a complaint.

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 on request, in our office and on this website.

Privacy officer

For questions about this notice or to exercise any of your rights, please contact our Privacy Officer:

Privacy Officer
National Robotic Spine Institute
1015 East CR-540a
Lakeland, FL 33813
frontdesk@robo-spine.com
1 (863) 226-1888

Effective date: November 2026