Last updated: October 23, 2026

Notice of Privacy Practices

Elite Care Health

Effective date: [EFFECTIVE DATE]

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.

This Notice is provided by Elite Care Health ("we," "us," or "our"), the health care provider that evaluates and treats patients who access care through the DemaFora Health membership. We are a "covered entity" under the Health Insurance Portability and Accountability Act (HIPAA).

Note on DemaFora Health: DemaFora Health ([LEGAL ENTITY NAME]) is a membership brand and does not practice medicine. DemaFora's own websites collect only waitlist and website information, which is covered by the DemaFora Privacy Policy, not this Notice. [COUNSEL TO CONFIRM DEMAFORA'S HIPAA ROLE — e.g., not a covered entity or business associate, or a business associate if it receives PHI.]

Our duties

We are required by law to:

• Maintain the privacy and security of your protected health information ("PHI")
• Give you this Notice of our legal duties and privacy practices
• Follow the terms of the Notice currently in effect
• Notify you if a breach occurs that may have compromised the privacy or security of your PHI

How we may use and share your health information

Treatment. We use and share your PHI to provide care — for example, sharing prescriptions with Rx Ave, ordering lab tests, or coordinating with other providers treating you.

Payment. We use and share PHI to bill and collect payment for services. [COUNSEL: services are cash-pay; confirm payment-related disclosures, e.g., to payment processors or the membership operator.]

Health care operations. We use and share PHI to run our practice, improve care, train staff, and conduct quality reviews.

Business associates. We share PHI with companies that perform services for us under written agreements that require them to protect it. This includes Karpa Health, which operates the technology platform for intake and related services. [ADD OTHER BUSINESS ASSOCIATES AS APPLICABLE.]

Other uses and disclosures permitted or required by law, including:

• When required by federal, state, or local law
• Public health and safety activities (e.g., reporting adverse drug reactions, preventing disease, product recalls)
• Reporting suspected abuse, neglect, or domestic violence
• Health oversight activities (audits, investigations, licensure)
• Lawsuits and legal proceedings, in response to a court order or subpoena
• Law enforcement purposes, as permitted by law
• To avert a serious threat to health or safety
• Coroners, medical examiners, and funeral directors
• Organ and tissue donation
• Research, under conditions permitted by law
• Specialized government functions (e.g., military, national security)
• Workers' compensation
• Communications with family or friends involved in your care, if you agree or do not object

[COUNSEL: add reproductive health care disclosure limitations and attestation requirements under any applicable HIPAA rule changes, and confirm current status.]

Uses that require your written authorization

We will not use or share your PHI for the following without your written authorization:

• Marketing purposes
• Sale of your PHI
• Most sharing of psychotherapy notes
• Any other use not described in this Notice

We do not share your PHI with advertising platforms (such as social media or search advertising companies) without your written authorization. You may revoke an authorization at any time in writing, except to the extent we have already relied on it.

More protective laws. Some state and federal laws give extra protection to certain information, such as substance use disorder treatment records, HIV/AIDS information, mental health information, and genetic information. We follow those laws where they apply.

Your rights

You have the right to:

• Get a copy of your health and claims records. Ask for an electronic or paper copy. We will provide it, usually within 30 days, and may charge a reasonable, cost-based fee.
• Ask us to correct your record if you think it is incorrect or incomplete. We may say no but will tell you why in writing within 60 days.
• Request confidential communications — for example, contact at a different address or by a specific method. We will say yes to reasonable requests.
• Ask us to limit what we use or share. We are not required to agree, except that if you pay for a service in full out-of-pocket, you can ask us not to share that information with your health insurer for payment or operations, and we will agree unless the law requires us to share it.
• Get a list of those with whom we've shared information (an "accounting of disclosures") for up to six years before your request, with certain exceptions.
• Get a copy of this Notice at any time, including a paper copy.
• Choose someone to act for you, such as a legal guardian or someone with medical power of attorney.
• File a complaint if you believe your privacy rights have been violated (see below).

To exercise these rights, contact our Privacy Officer at the contact information below.

Complaints

You can file a complaint with us using the contact information below, or 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 www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

Changes to 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 on request and on our website.

Contact — Privacy Officer

Elite Care Health Attn: Privacy Officer [PROVIDER GROUP ADDRESS] Email: [PROVIDER GROUP PRIVACY EMAIL] Phone: [PROVIDER GROUP PHONE]