Notice of Privacy Practice (HIPAA)
Effective Date: September 2026
This notice describes how your medical information may be used and disclosed and how you can access this information. Please review it carefully.
Rooted To Bloom Functional Medicine, PLLC (“Rooted To Bloom Functional Medicine”) is required by law to maintain the privacy and security of your Protected Health Information (PHI) and to provide you with this Notice describing our legal duties and privacy practices.
We reserve the right to revise this Notice at any time. Any revisions will apply to all PHI we maintain. Updated Notices will be made available upon request and will be posted on our website when required.
Your Rights
You have the following rights regarding your Protected Health Information:
Access to your medical records: You may request access to and copies of your medical records, subject to applicable federal and Minnesota law.
Electronic access: You may request your health information in an electronic format when available and permitted by law.
Request corrections: You may request that we correct information in your medical records that you believe is incorrect or incomplete. We may deny a request as permitted by law.
Confidential communications: You may request that we communicate with you about your health information in a certain way or at a certain location. We will accommodate reasonable requests as required by law.
Request restrictions: You may request restrictions on certain uses or disclosures of your PHI. We are not required to agree to every restriction request, except where required by law.
Accounting of certain disclosures: You may request a list of certain disclosures of your PHI made by us, subject to exceptions provided by law.
Paper copy of this Notice: You may request a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
Personal representative: You may choose a person to act on your behalf regarding your health information when permitted by law. A personal representative may exercise certain rights on your behalf, subject to applicable law.
To exercise these rights, please contact the practice. Certain requests may require written documentation as permitted by law.
How We May Use and Disclose Your Information
Treatment
We may use and disclose your PHI to provide, coordinate, and manage your care. This may include communication with healthcare providers, pharmacies, laboratories, and other healthcare entities involved in your treatment.
Payment
We may use and disclose your PHI as necessary for payment-related activities, including processing payments, maintaining financial records, communicating regarding balances due, and collecting outstanding amounts owed for services provided.
Healthcare Operations
We may use and disclose your PHI for healthcare operations and administrative purposes, including quality improvement, care coordination, scheduling, training, administrative activities, and communication with you regarding your care.
We limit uses and disclosures of PHI to the minimum necessary to accomplish the intended purpose when required by law.
Uses and disclosures of your PHI for purposes not described in this Notice will require your written authorization unless otherwise permitted or required by law.
Other Permitted or Required Disclosures
We may use or disclose your PHI without your written authorization when permitted or required by law, including for purposes such as:
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Compliance with federal, state, or local laws.
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Public health activities and protection of public health and safety.
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Health oversight activities.
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Court orders, subpoenas, or other lawful legal processes.
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Law enforcement purposes as permitted by law.
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Workers’ compensation matters.
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Preventing or responding to serious threats to health or safety.
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Food and Drug Administration activities, including reporting certain adverse events or product problems and supporting product recalls when required or permitted by law.
Substance Use Disorder Records
If Rooted To Bloom Functional Medicine maintains records that are subject to the federal confidentiality protections applicable to certain substance use disorder treatment records under 42 CFR Part 2, those records will be used and disclosed only as permitted by applicable federal law.
Marketing and Sale of Health Information
Rooted To Bloom Functional Medicine does not sell your Protected Health Information.
We will not use or disclose your PHI for marketing purposes in a manner that requires your written authorization without obtaining that authorization as required by law.
Communication
We may contact you by secure patient portal, phone, text message, or email regarding appointments, laboratory coordination, results, follow-up care, billing matters, and other administrative or clinical communications related to your care when appropriate.
The secure patient portal is our preferred method for communication involving sensitive health information whenever practical.
Electronic communications may involve inherent privacy and security risks despite reasonable safeguards. Rooted To Bloom Functional Medicine is not responsible for delays, transmission failures, or technical issues beyond its reasonable control.
Family Members and Others Involved in Your Care
We may disclose relevant PHI to family members or other persons involved in your care when you provide consent, do not object, or when otherwise permitted by law. In emergency situations, we may disclose information when permitted or required by law to protect your health or safety.
Research
We will not use or disclose your PHI for research purposes without your written authorization unless otherwise permitted or required by law.
Our Responsibilities
Rooted To Bloom Functional Medicine is required by law to:
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Maintain the privacy and security of your PHI.
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Provide you with this Notice describing our legal duties and privacy practices.
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Follow the terms of the Notice currently in effect.
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Notify you as required by law if a breach occurs that compromises the privacy or security of your PHI.
We reserve the right to change this Notice and make the revised Notice applicable to all PHI we maintain. The current Notice will be available upon request and posted on our website when required.
Complaints
If you believe your privacy rights have been violated, you may contact Rooted To Bloom Functional Medicine directly or file a complaint with the U.S. Department of Health and Human Services.
You will not be retaliated against for filing a complaint.
Minnesota Health Records Law Compliance
In addition to federal HIPAA protections, your rights are also protected under Minnesota health records law.
Under applicable Minnesota law and HIPAA:
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You may request access to and copies of your health records.
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Records will be provided within the timeframes required under applicable federal and Minnesota law.
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You may request records in electronic format when available.
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Fees for copies may be charged as permitted by Minnesota law.
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No fee will be charged when a patient requests records for purposes of reviewing current medical care.
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Identity verification may be required prior to release of records.
Contact Information
Rooted To Bloom Functional Medicine, PLLC
308 5th Ave S., Suite 140
Cold Spring, MN 56320
If you have questions regarding this Notice or your privacy rights, please contact Rooted To Bloom Functional Medicine through the contact form on our website.