Notice of Privacy Practices

HIPAA Notice of Privacy Practices

Effective Date: July 2026

THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Commitment

LumiLife Aesthetics + Wellness is committed to protecting the privacy and confidentiality of your protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable Connecticut law.

We May Use Your Health Information For

Treatment

To provide medical care and coordinate your treatment.

Examples include:

• consultations 
• medical evaluations 
• photographs used for treatment planning 
• follow-up care 
• referrals when appropriate 

Payment

To collect payment for services provided.

Although most aesthetic services are self-pay, your information may be used to process payments or provide receipts.

Healthcare Operations

To improve quality of care through:

• staff training 
• quality improvement 
• accreditation 
• risk management 
• compliance activities 

Other Permitted Uses

We may disclose information:

• when required by law 
• public health reporting 
• law enforcement requests 
• court orders 
• preventing serious threats to health or safety 
• workers’ compensation when applicable 

Uses Requiring Your Authorization

We will obtain your written authorization before:

• using photographs for marketing 
• sharing medical information for marketing purposes 
• disclosing information not otherwise permitted by HIPAA 

You may revoke your authorization at any time in writing.

Your Rights

You have the right to:

✔ inspect your medical records

✔ request copies

✔ request corrections

✔ request restrictions on certain disclosures

✔ request confidential communications

✔ receive an accounting of certain disclosures

✔ obtain a paper copy of this Notice

Our Responsibilities

We are required by law to:

• protect your health information 
• provide this Notice 
• follow the terms of this Notice 
• notify you if a breach of unsecured protected health information occurs 

Questions or Complaints

If you believe your privacy rights have been violated, you may contact:

Privacy Officer

LumiLife Aesthetics + Wellness

225 Main Street, Office #7

Westport, CT 06880

Phone:

(203) 557-3144

Email:

info@lumilifeaw.com

You may also file a complaint with the U.S. Department of Health & Human Services.

You will not be retaliated against for filing a complaint.