Effective Date: [1/10/25]
Hali’a Therapeutics
576 Olive Street, Suite 205, Eugene, OR 97401
www.haliaot.com | Info@haliaot.com

This Notice describes how medical information about you or your child may be used and disclosed, and how you can access this information. Please review it carefully.

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Our Responsibilities

Hali’a Therapeutics is committed to protecting your privacy. We are required by law to:
   •    Maintain the privacy of your protected health information (PHI).
   •    Provide you with this Notice of our legal duties and privacy practices.
   •    Abide by the terms of this Notice currently in effect.
   •    Notify you in the event of a breach involving your unsecured PHI.

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How We May Use and Disclose Your Information

We may use or disclose your health information for the following reasons:

Treatment

To provide, coordinate, or manage your care. For example, we may share your information with your midwife, pediatrician, or lactation consultant if collaborating on care. It may also be shared with mentors to provide you with the best care possible and work towards your goals. 

Payment

To bill and collect payment for services. For example, we may share necessary information with your insurance provider or a billing service.

Healthcare Operations

For internal purposes such as quality improvement, staff training, or compliance review.

With Your Authorization

Other uses or disclosures not covered by this Notice (such as sharing information for marketing or social media) will only be made with your written permission. You may revoke that authorization at any time in writing.

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Other Permitted or Required Uses

We may also disclose your information in the following situations:
   •    When required by law (e.g., public health, child abuse reporting)
   •    For health oversight activities
   •    In legal proceedings, if ordered by a court
   •    To avoid a serious threat to health or safety
   •    For research purposes, with your consent
   •    With school or early intervention programs, if relevant to your child’s care and with your written consent

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Your Rights Regarding Your Health Information

You have the right to:
   •    Inspect and request a copy of your health records
   •    Request corrections to your records
   •    Request confidential communications, such as only being contacted by email or phone
   •    Request restrictions on how your information is used or shared
   •    Receive an accounting of disclosures we’ve made of your information
   •    Receive a paper copy of this Notice
   •    File a complaint if you believe your privacy rights have been violated (see below)

Requests must be submitted in writing to the contact listed below.

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Changes to This Notice

We reserve the right to update this Notice at any time. The new Notice will be posted in our office and on our website, with the effective date clearly indicated.

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Contact Information

If you have questions or wish to exercise your privacy rights, please contact:

Hali’a Therapeutics – Privacy Officer
Email: info@haliaot.com
Phone: (541) 313-4153
Address: 576 Olive Street, Suite 205, Eugene, OR 97401

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights if you feel your rights have been violated. We will not retaliate against you for filing a complaint.