BE ENV Wellness & Aesthetics 16652 Sheridan Street | Pembroke Pines, Florida 33331
Phone: [954-887-3368] Website: www.beenvwellness.com
Effective Date: May 13, 2026 Last Revised: May 13, 2026
T H I S N O T I C E D E S C R I B E S H O W M E D I C A L I N F O R M A TI O N A B O U T Y O U M A Y B E
U S E D A N D D I S C L O S E D A N D H O W Y O U C A N G E T A C C E S S T O T H I S I N F O R M A TI O N .
P L E A S E R E V I E W I T C A R E F U L L Y .
Our Commitment to Your Privacy
BE ENV Wellness & Aesthetics (“BE ENV,
” “we,
” “us,
” or “our”) is committed to
protecting the privacy of your health information. We are required by law to maintain
the privacy of your protected health information (“PHI”), to provide you with this
Notice of our legal duties and privacy practices with respect to your PHI, and to notify
you following a breach of your unsecured PHI. We are required to abide by the terms of
this Notice while it is in effect. We reserve the right to change the terms of this Notice
and to make the new Notice effective for all PHI we maintain. If we revise this Notice,
we will post the revised version on our website at www.beenvwellness.com and make
it available at our office.
Part I — How We May Use and Disclose Your Health
Information
The following describes the ways we may use and disclose your PHI. Not every use or
disclosure in a category will be listed, but all of the ways we are permitted to use and
disclose information will fall within one of the categories.1. Treatment
We may use and disclose your PHI to provide, coordinate, or manage your health care
and related services. For example, we may share information about your treatment
with other health care providers involved in your care, such as a referring physician,
specialist, pharmacist, or laboratory. We may also use your PHI to contact you to
provide appointment reminders or information about treatment alternatives.
2. Payment
We may use and disclose your PHI to obtain payment for services we provide to you.
For example, we may submit claims to your health insurance plan and include
information about the services you received so your insurer can pay for or reimburse
you for those services. We may also disclose your PHI to a collection agency if
necessary to collect payment for services rendered.
3. Health Care Operations
We may use and disclose your PHI for our health care operations. These uses and
disclosures are necessary to run our practice and ensure that all of our patients receive
quality care. For example, we may use your PHI to review the quality and competence
of our clinical staff, conduct training programs, conduct business planning activities,
or resolve patient complaints.
4. Appointment Reminders and Health-Related Communications
We may use your PHI to contact you with appointment reminders, information about
treatment options, or other health-related benefits and services that may be of
interest to you. We may contact you by phone, text message, email, or mail. You have
the right to request that we communicate with you by alternative means or at
alternative locations (see Your Rights section below).
5. Required by Law
We will disclose your PHI when required to do so by federal, state, or local law. This
includes, but is not limited to, disclosures required by Florida law (Fla. Stat. § 456.057)
and applicable federal regulations.6. Public Health Activities
We may disclose your PHI to public health authorities for activities authorized by law,
such as reporting communicable diseases, reporting adverse events related to
medications or medical devices, or reporting to the Florida Department of Health.
7. Health Oversight Activities
We may disclose your PHI to a health oversight agency for activities authorized by law,
such as audits, investigations, inspections, and licensure. These activities are
necessary for the government to monitor the health care system, government
programs, and compliance with civil rights laws. Oversight agencies include the
Florida Board of Nursing, the Florida Department of Health, and the U.S. Department
of Health and Human Services (HHS).
8. Judicial and Administrative Proceedings
We may disclose your PHI in response to a court or administrative order, subpoena,
discovery request, or other lawful process. We will make reasonable efforts to notify
you of such requests or to obtain an order protecting the information requested.
9. Law Enforcement
We may disclose your PHI to law enforcement officials for limited purposes, including
to identify or locate a suspect, fugitive, material witness, or missing person; to report a
crime on our premises; or as required by law.
10. Serious Threats to Health or Safety
We may use or disclose your PHI when necessary to prevent a serious and imminent
threat to your health or safety or the health or safety of the public or another person,
consistent with applicable law and standards of ethical conduct.
11. Workers’ Compensation
We may disclose your PHI as authorized by and to the extent necessary to comply with
Florida workers’ compensation laws.12. Coroners, Medical Examiners, and Funeral Directors
We may disclose your PHI to a coroner or medical examiner for the purpose of
identifying a deceased person or determining the cause of death. We may also disclose
PHI to funeral directors as necessary to carry out their duties.
13. Research
We may use or disclose your PHI for research purposes when an institutional review
board or privacy board has approved the research and established protocols to ensure
the privacy of your information. We will ask for your specific authorization before using
your PHI for most research purposes.
14. Substance Use Disorder Records
As required by federal law (42 U.S.C. § 290dd-2 and 42 CFR Part 2, effective February
16, 2026), if we maintain records related to substance use disorder (SUD) treatment,
those records are subject to additional federal protections. SUD records may not be
disclosed without your written consent except in limited circumstances permitted by
law, including medical emergencies, audits and evaluations, and court orders. We will
inform you separately if your records are subject to Part 2 protections.
Part II — Uses and Disclosures That Require Your
Written Authorization
For uses and disclosures of your PHI not described in Part I above, we will ask for your
written authorization. You may revoke an authorization in writing at any time. If you
revoke your authorization, we will no longer use or disclose your PHI for the reasons
covered by your written authorization, except to the extent that we have already taken
action in reliance on your authorization.
The following uses and disclosures will never be made without your written
authorization:
Marketing. We will not use or disclose your PHI for marketing purposes without
your written authorization, except for face-to-face communications we make with
you and promotional gifts of nominal value.Sale of PHI. We will not sell your PHI without your written authorization.
Psychotherapy Notes. We will not use or disclose psychotherapy notes without
your written authorization (except in limited circumstances permitted by law).
Most Uses of Highly Sensitive Information. We will obtain your written
authorization before using or disclosing PHI that is particularly sensitive,
including information about HIV/AIDS status, mental health treatment, genetic
information, and reproductive health care information, except as permitted or
required by law.
Part III — Your Rights Regarding Your Health
Information
You have the following rights with respect to your PHI. To exercise any of these rights,
please submit a written request to our Privacy Officer at the address listed at the end
of this Notice.
Right to Inspect and Copy
You have the right to inspect and obtain a copy of PHI that we maintain about you in a
designated record set, which generally includes your medical and billing records. We
may charge a reasonable, cost-based fee for copies. We must provide you with access
to your records within 30 days of your request (or 60 days if the records are stored off-
site). In limited circumstances, we may deny your request; if we do, we will tell you
why and explain your right to have the denial reviewed.
Right to an Electronic Copy
If your PHI is maintained in an electronic health record, you have the right to request
an electronic copy of your PHI in a format you specify, if it is readily producible in that
format.
Right to Request an Amendment
If you believe that PHI we have about you is incorrect or incomplete, you may request
that we amend it. We may deny your request if we determine that the information isaccurate and complete, was not created by us, is not part of the records we maintain,
or is not information you would be permitted to inspect. If we deny your request, we
will explain why in writing.
Right to an Accounting of Disclosures
You have the right to request an accounting of certain disclosures of your PHI made by
us in the six years prior to your request. This accounting will not include disclosures
made for treatment, payment, or health care operations; disclosures made to you;
disclosures made pursuant to your authorization; or certain other disclosures. We will
provide the first accounting you request during any 12-month period at no charge. We
may charge a reasonable fee for additional requests in the same 12-month period.
Right to Request Restrictions
You have the right to request restrictions on how we use or disclose your PHI for
treatment, payment, or health care operations. You also have the right to request that
we restrict disclosures to family members, friends, or other persons involved in your
care. We are required to agree to your request to restrict disclosure of your PHI to
a health plan if the disclosure is for payment or health care operations purposes
and the PHI pertains solely to a health care item or service for which you have
paid out of pocket in full.
Right to Request Confidential Communications
You have the right to request that we communicate with you about your health
matters in a certain way or at a certain location. For example, you may ask that we
contact you only at a specific phone number or by email. We will accommodate all
reasonable requests. We will not ask you to explain the reason for your request.
Right to a Paper Copy of This Notice
You have the right to a paper copy of this Notice at any time, even if you have agreed to
receive this Notice electronically. You may request a paper copy by contacting us at the
address below.Right to Be Notified of a Breach
You have the right to be notified if your unsecured PHI is breached. We will notify you
without unreasonable delay and no later than 60 days after we discover the breach, as
required by 45 CFR § 164.404.
Part IV — Our Legal Duties
We are required by law to:
Maintain the privacy of your PHI.
Provide you with this Notice of our legal duties and privacy practices with respect
to your PHI.
Notify you following a breach of your unsecured PHI.
Abide by the terms of this Notice while it is in effect.
We reserve the right to change our privacy practices and the terms of this Notice at any
time, provided such changes are permitted by applicable law. We will post the revised
Notice on our website and make it available at our office. The new Notice will be
effective for all PHI we maintain at that time.
Part V — Complaints
If you believe your privacy rights have been violated, you may file a complaint with us
or with the Secretary of the U.S. Department of Health and Human Services. To file a
complaint with us, contact our Privacy Officer using the information below. To file a
complaint with HHS, visit www.hhs.gov/hipaa/filing-a-complaint or call 1-800-368-
1019 (TDD: 1-800-537-7697).
We will not retaliate against you for filing a complaint.Contact Information — Privacy Officer
Privacy Officer BE ENV Wellness & Aesthetics 16652 Sheridan Street Pembroke Pines,
Florida 33331 Phone: [INSERT PHONE NUMBER] Email: [INSERT PRIVACY EMAIL, e.g.,
privacy@beenvwellness.com] Website: www.beenvwellness.com
Acknowledgment of Receipt
By receiving services at BE ENV Wellness & Aesthetics, you acknowledge that you have
been offered this Notice of Privacy Practices. If you have any questions about this
Notice or our privacy practices, please contact our Privacy Officer.
T h i s N o t i c e o f P r i v a c y P r a c t i c e s i s b a s e d o n t h e H I P A A P r i v a c y R u l e (45 C F R P a r t s 160
a n d 164 ) , t h e 2024 H I P A A P r i v a c y R u l e Fi n a l R u l e , a n d t h e 2024 P a r t 2 F i n a l R u l e (42
C F R P a r t 2 ) , e ff e c t i v e F e b r u a r y 16 , 2026 . I t c o m p l i e s w i t h Fl o r i d a S t a t u t e s § 456 .057
( m e d i c a l r e c o r d s a c c e s s a n d r e t e n t i o n ) a n d a p p l i c a bl e s t a t e p r i v a c y l a w s .
E ff e c t i v e D a t e : M a y 13 , 2026 | L a s t R e v i e w e d : M a y 13 , 2026