NOTICE OF PRIVACY PRACTICES
SAVI Aesthetics and Dermatology
Effective Date: 12/1/2026
Privacy Contact: Kylie Buchholz
Address: 4908 Stockholm Loop Studio 2, Bismarck, ND
Phone: 701-606-1996
Website: www.saviaesthetics.com
This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.
SAVI Aesthetics and Dermatology is committed to protecting the privacy and confidentiality of your personal health information. We are required by applicable law to maintain the privacy and security of your protected health information (PHI), provide you with this Notice of Privacy Practices, and follow the terms of the notice currently in effect.
Protected health information includes information that identifies you and relates to your past, present, or future physical or mental health, healthcare services, or payment for healthcare.
1. HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
We may use or disclose your protected health information without your written authorization for certain purposes permitted or required by law.
Treatment
We may use and share your health information to provide, coordinate, or manage your medical care.
Examples include:
Documenting medical dermatology and aesthetic consultations, diagnoses, procedures, and treatment plans.
Reviewing medical history, medications, allergies, and previous treatments.
Communicating with other healthcare professionals involved in your care.
Ordering or reviewing laboratory tests, prescriptions, or referrals.
Documenting clinical photographs for medical assessment and treatment planning.
Payment
We may use and disclose your health information to collect payment for services provided.
This may include processing payments, providing itemized receipts or superbills, submitting insurance claims when applicable, and responding to payment-related inquiries.
Healthcare Operations
We may use and disclose your information for activities necessary to operate our practice.
Examples include:
Maintaining and reviewing medical records.
Quality improvement and patient safety activities.
Administrative and business operations.
Compliance with legal and regulatory requirements.
Working with vendors that provide electronic medical records, billing, or other practice management services under appropriate privacy agreements.
2. OTHER PERMITTED OR REQUIRED DISCLOSURES
We may use or disclose your health information without your written authorization when permitted or required by law, including:
Public Health Activities: Reporting certain communicable diseases, adverse events, or other information to authorized public health agencies.
Health Oversight Activities: Cooperating with authorized audits, investigations, inspections, or licensing activities.
Required by Law: Disclosing information when required by applicable federal or state law.
Law Enforcement and Legal Proceedings: Responding to lawful requests, court orders, subpoenas, or other legal processes when the applicable requirements for disclosure are satisfied.
Serious Threats to Health or Safety: Disclosing information when necessary and permitted by law to prevent or lessen a serious threat to health or safety.
Workers' Compensation: Disclosing information as authorized by workers' compensation laws.
Medical Examiners and Coroners: Disclosing information for legally authorized purposes.
Specialized Government Functions: Making disclosures for certain military, national security, or other authorized government purposes.
We may also disclose information to appropriate authorities concerning suspected abuse, neglect, or domestic violence when permitted or required by law.
3. APPOINTMENT REMINDERS AND ELECTRONIC COMMUNICATIONS
We may contact you regarding appointments, scheduling, follow-up care, treatment instructions, prescriptions, or other healthcare-related matters.
Communications may occur by telephone, voicemail, text message, email, patient portal, or other communication methods, as appropriate and consistent with applicable privacy requirements.
We take reasonable precautions to protect your information. However, ordinary email and text messages may present privacy or security risks.
You may request that we communicate with you using a particular method or at a particular location. We will accommodate reasonable requests as required by law.
Separate authorization or consent may be requested for certain electronic communications when appropriate.
4. CLINICAL PHOTOGRAPHY
Clinical photographs may be taken as part of your medical record to document treatment areas, evaluate progress, support clinical decision-making, and compare treatment outcomes.
These photographs are considered protected health information when they identify you or are maintained as part of your identifiable medical record.
Photographs will not be used for marketing, social media, advertising, or other promotional purposes without your separate written authorization, unless otherwise permitted by law.
Declining authorization for promotional photography will not affect your ability to receive treatment.
5. USES AND DISCLOSURES REQUIRING YOUR AUTHORIZATION
Certain uses or disclosures of your health information require your written authorization, including:
Most uses and disclosures for marketing purposes that require authorization under HIPAA.
Sale of protected health information.
Most uses and disclosures of psychotherapy notes, if applicable.
Identifiable patient photographs or information used for promotional purposes when authorization is required.
Other uses or disclosures not otherwise permitted or required by law.
You may revoke a written authorization at any time by submitting a written request, except to the extent we have already acted in reliance on that authorization.
6. ADDITIONAL PROTECTIONS FOR CERTAIN HEALTH INFORMATION
Certain types of health information may receive additional protection under federal or state law.
These may include records relating to substance use disorder treatment, mental health services, or other specially protected information.
Records subject to the federal confidentiality regulations at 42 CFR Part 2 may have additional restrictions on use and disclosure. When applicable, we will comply with those requirements.
Part 2 records generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against a patient without the patient's specific written consent or an appropriate court order that satisfies applicable federal requirements.
When Part 2 records are disclosed with consent for treatment, payment, or healthcare operations, certain further uses and disclosures may be permitted under HIPAA, subject to applicable restrictions.
Where required by law, we will obtain authorization or consent before using or disclosing specially protected information.
7. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the following rights concerning your protected health information.
Right to Access Your Records
You may request to inspect or obtain a copy of your medical records and other health information maintained in a designated record set.
We will generally respond within 30 days, subject to permitted extensions and exceptions. Reasonable, cost-based fees may apply when allowed by law.
Right to Request Corrections
If you believe information in your medical record is incorrect or incomplete, you may request an amendment.
We may deny certain requests as permitted by law and will explain the reason for any denial.
Right to Request Confidential Communications
You may request that we contact you using a specific telephone number, mailing address, email address, or other reasonable communication method.
We will accommodate reasonable requests as required by law.
Right to Request Restrictions
You may request restrictions on how your information is used or disclosed for treatment, payment, or healthcare operations.
We are not required to agree to every requested restriction.
However, if you pay out of pocket in full for a healthcare service and request that information about that service not be disclosed to your health plan for payment or healthcare operations, we generally must honor that request unless disclosure is required by law.
Right to an Accounting of Disclosures
You may request an accounting of certain disclosures of your protected health information made during the preceding six years, subject to applicable exceptions.
Right to a Paper Copy
You may request a paper copy of this Notice of Privacy Practices at any time, even if you previously agreed to receive it electronically.
Right to Choose a Personal Representative
If someone has legal authority to act on your behalf regarding healthcare decisions or health information, that person may exercise certain privacy rights on your behalf, subject to applicable law.
Right to File a Complaint
You have the right to file a complaint if you believe your privacy rights have been violated.
You may file a complaint directly with SAVI Aesthetics and Dermatology or with the U.S. Department of Health and Human Services Office for Civil Rights.
We will not retaliate against you for filing a privacy complaint.
8. OUR RESPONSIBILITIES
SAVI Aesthetics and Dermatology is responsible for:
Maintaining the privacy and security of your protected health information as required by law.
Implementing appropriate administrative, physical, and technical safeguards.
Limiting uses and disclosures of health information as required by applicable privacy laws.
Providing you with this Notice of Privacy Practices.
Following the terms of the notice currently in effect.
Notifying affected individuals following a breach of unsecured protected health information when notification is required by law.
Obtaining written authorization for uses or disclosures that require authorization.
We may change our privacy practices and the terms of this notice as permitted by law.
If changes are made, the revised notice may apply to all protected health information we maintain, including information created or received before the revision.
The current notice will be available upon request, at our practice, and on our website.
9. QUESTIONS OR PRIVACY COMPLAINTS
If you have questions about this notice, would like to exercise your privacy rights, or wish to file a complaint, please contact:
SAVI Aesthetics and Dermatology
Privacy Contact: Kylie Buchholz
Address: 4908 Stockholm Loop Studio 2, Bismarck, ND
Phone: 701-606-1996
Website: www.saviaesthetics.com
You may also submit a complaint to:
U.S. Department of Health and Human Services
Office for Civil Rights
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/
Complaints may be submitted electronically or by mail according to HHS instructions.
You will not be penalized or retaliated against for filing a complaint.
10. EFFECTIVE DATE
This Notice of Privacy Practices is effective as of: 12/1/2026
SAVI Aesthetics and Dermatology reserves the right to revise this notice as permitted by law. The most current version will be available through the practice and on our website.