WHAT DO WE DO WITH YOUR INFORMATION?

When you purchase something from our site or submit information to schedule an appointment, we collect the personal information you give us such as your name, address, email address, and relevant health information.

When you browse our site, we also automatically receive your computer's IP address to help us understand your browser and device.

With your permission, we may also send you emails about Fountain's services, wellness content, or updates to our programs.

CONSENT

How do you get my consent?

When you provide us with personal information to complete a form, schedule an appointment, verify your payment information, or initiate care, we imply that you consent to our collecting it and using it for that specific reason only.

If we request your personal information for a secondary reason, like marketing, we will either ask you directly for your expressed consent or provide you with an opportunity to opt out.

How do I withdraw my consent?

If you change your mind after opting in, you may withdraw your consent for us to contact you or continue collecting, using, or disclosing your information at any time by contacting us at admin@fountainnyc.com

DISCLOSURE

We may disclose your personal information if required by law, or if you violate our Terms of Service.

THIRD-PARTY SERVICES

In general, the third-party providers we use will collect, use, and disclose your information only to the extent necessary to perform the services they provide to Fountain.

Certain providers—such as payment processors—have their own privacy policies that govern how they handle the information we are required to provide to them. We recommend reviewing their privacy policies to understand how your data will be handled.

Please note that some providers may be located in or operate from a different jurisdiction. If you choose to proceed with a transaction involving a third-party provider, your information may become subject to the laws of the jurisdiction where that provider or its facilities are located.

For example, if you are located in Canada and your transaction is processed by a provider in the United States, then your personal information used in completing that transaction may be subject to U.S. laws.

Once you leave our website or are redirected to a third-party site or platform, this Privacy Policy and our Terms of Service no longer apply.

Links

Our website may contain links to other sites. We are not responsible for the privacy practices of those sites and encourage you to review their privacy policies.

Google Analytics

We use Google Analytics to better understand how visitors interact with our site, such as what pages are viewed and for how long.

SECURITY

We take reasonable precautions and follow industry best practices to protect your personal information from being lost, misused, accessed, disclosed, altered, or destroyed.

All payment processing is handled by a third-party processor that uses encryption and secure infrastructure consistent with modern data protection standards. We do not store full credit card information on our servers.

AGE OF CONSENT

By using this site, you confirm that you are at least the age of majority in your state or province of residence, or that you are the age of majority and have given your consent to allow any minor dependents to use this site.

HIPAA COMPLIANCE

Fountain is committed to protecting your health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA). We use and disclose your protected health information (PHI) only for treatment, payment, or healthcare operations—or as otherwise required by law.

Your Rights Under HIPAA:

• Request restrictions on how we use/disclose your PHI
• Receive confidential communications
• Inspect and request copies of your medical records
• Request amendments to your health information
• Receive an accounting of disclosures
• Receive a paper copy of this notice

We maintain physical, technical, and administrative safeguards to ensure the confidentiality and integrity of your health information.

CHANGES TO THIS PRIVACY POLICY

We reserve the right to modify this privacy policy at any time. Changes will take effect immediately upon posting. If we make material changes, we will notify you here so that you are aware of what we collect, how we use it, and under what circumstances we disclose it.

If Fountain is acquired or merged with another organization, your information may be transferred so that services may continue.

Your Information. Your Rights. Our Responsibilities.

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.

Your Rights

You have the right to:

• Get a copy of your paper or electronic medical record
• Correct your paper or electronic medical record
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we've shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated

Your Choices

You have some choices in the way that we use and share information as we:

• Tell family and friends about your condition
• Provide disaster relief
• Include you in a hospital directory
• Provide mental health care
• Market our services and sell your information
• Raise funds

Our Uses and Disclosures

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper 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. Ask us how to do this.

We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.

We may say "no" to your request, but we'll tell you why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, 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 to your request, and we may say "no" if it would affect your care.

If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say "yes" unless a law requires us to share that information.

Get a list of those with whom we've shared information

You can ask for a list (accounting) of the times we've shared your health information for six years prior to the date you ask, who we shared it with, and why.

We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We'll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

You can complain if you feel we have violated your rights by contacting us using the information on page 1.

You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting https://www.hhs.gov/ocr/privacy/hipaa/complaints/.

We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation
• Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes

In the case of fundraising:

We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Uses and Disclosures

How do we typically use or share your health information?

We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: https://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues

We can share health information about you for certain situations such as:

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone's health or safety

Do research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we're complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers' compensation, law enforcement, and other government requests

We can use or share health information about you:

• For workers' compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.

We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

We must follow the duties and privacy practices described in this notice and give you a copy of it.

We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: https://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Use of Cookies

The Web site uses "cookies" to help this Practice personalize your online experience. A cookie is a text file that is placed on your hard disk by a Web page server. Cookies cannot be used to run programs or deliver viruses to your computer. Cookies are uniquely assigned to you, and can only be read by a web server in the domain that issued the cookie to you.

Security of your Personal Information

This Practice secures your personal information from unauthorized access, use or disclosure. This Practice secures the personally identifiable information you provide on computer servers in a controlled, secure environment, protected from unauthorized access, use or disclosure. When personal information (such as a credit card number) is transmitted to other Web sites, it is protected through the use of encryption, such as the Secure Socket Layer (SSL) protocol.

Changes to the Terms of 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 upon request, in our office, and on our web site.

Effective Date

The Effective date of this notice is 5/1/2025.

Privacy Officer

You may contact the Privacy Officer by: (631) 398-1518, 425 E 86th Street, Suite 1A, New York, NY 10028, admin@fountainnyc.com