Notice of Privacy Practices
AK Wellness, PLLC
Effective Date: October 7, 2026
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.
AK Wellness, PLLC is committed to protecting the privacy and security of your protected health information (“PHI”). This Notice describes your rights regarding your health information and how AK Wellness may use and disclose that information.
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities.
Get an electronic or paper copy of your medical record
You can ask to see or obtain an electronic or paper copy of your medical record and other health information we maintain about you.
We will provide a copy or summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee as permitted by law.
Ask us to correct your medical record
You can ask us to correct health information about you that you believe is incorrect or incomplete.
We may deny your request in certain circumstances, but we will explain the reason in writing, generally within 60 days.
Request confidential communications
You can ask us to contact you in a specific way—for example, by phone rather than email—or to send communications to a different address.
We will accommodate reasonable requests.
Ask us to limit what we use or share
You can ask us not to use or disclose certain health information for treatment, payment, or healthcare operations. We are generally not required to agree to your request.
If you pay for a healthcare service or item out of pocket in full, you may ask us not to disclose information about that service or item to your health plan for purposes of payment or healthcare operations. We will honor that request unless disclosure is required by law.
Get a list of certain disclosures
You can ask for an accounting of certain disclosures of your health information made during the six years before the date of your request.
The accounting will not include certain disclosures, such as disclosures for treatment, payment, or healthcare operations or disclosures you specifically authorized.
We will provide one accounting during any 12-month period at no charge. We may charge a reasonable, cost-based fee for additional requests within the same 12-month period.
Get a 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.
Choose someone to act for you
If you have given someone medical power of attorney, or if someone is your legal guardian or otherwise legally authorized to act for you, that person may exercise your rights and make choices about your health information as permitted by law.
We will verify that the person has appropriate authority before taking action.
File a complaint if you believe your privacy rights have been violated
You may contact AK Wellness if you believe your privacy rights have been violated:
AK Wellness, PLLC
Alani Kalfayan, MSN, FNP-C
Email: alani@alanikwellness.com
Phone: (424) 257-6494
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.
HHS Office for Civil Rights Complaint Portal
You may also contact HHS at:
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-877-696-6775
AK Wellness will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you may tell us your preferences about what we share.
You may tell us whether you want us to:
Share information with family members, close friends, or others involved in your care or payment for your care
Share information in a disaster-relief situation
If you are unable to communicate your preference—for example, because you are unconscious—we may share information when we believe doing so is in your best interest and is permitted by law. We may also share information when necessary to lessen a serious and imminent threat to health or safety.
Uses and disclosures requiring authorization
We will obtain your written authorization before using or disclosing your health information for purposes requiring authorization under applicable law, including most uses and disclosures for marketing purposes, the sale of your health information, and most disclosures of psychotherapy notes.
If you provide written authorization, you may revoke it in writing at any time, except to the extent we have already acted in reliance on it.
Our Uses and Disclosures
We typically use or share your health information in the following ways.
Treat you
We may use your health information and share it with other healthcare professionals involved in your treatment.
Example: We may share relevant health information with another healthcare professional involved in your care.
Run our organization
We may use and disclose your health information to operate our practice, improve the quality of care we provide, and contact you when necessary.
Example: We may use health information to coordinate services, conduct quality assessment activities, or manage our practice.
Bill for your services
We may use and disclose your health information for billing and payment activities when applicable.
Example: We may provide information necessary to process payment or reimbursement for healthcare services.
Other Ways We May Use or Share Your Information
We may be permitted or required to use or disclose your health information for certain other purposes. These uses and disclosures are subject to applicable legal requirements.
Help with public health and safety
We may disclose health information for certain public health and safety activities, including:
Preventing or controlling disease
Assisting with product recalls
Reporting adverse reactions to medications
Reporting suspected abuse, neglect, or domestic violence when authorized or required by law
Preventing or reducing a serious threat to health or safety
Conduct health research
We may use or disclose health information for research when permitted by law and when applicable privacy protections have been satisfied.
Comply with the law
We will disclose information when federal or state law requires us to do so, including to the U.S. Department of Health and Human Services when it is reviewing our compliance with federal privacy laws.
Respond to organ and tissue donation requests
We may disclose health information to organ procurement organizations and other entities involved in organ, eye, or tissue donation or transplantation as permitted by law.
Work with medical examiners and funeral directors
We may disclose health information to a coroner, medical examiner, or funeral director when permitted or required by law.
Address workers' compensation, law enforcement, and government requests
We may use or disclose health information:
For workers' compensation claims
For certain law-enforcement purposes
To health oversight agencies for activities authorized by law
For certain special government functions, including military, national security, and protective services
Respond to lawsuits and legal proceedings
We may disclose health information in response to a court or administrative order, subpoena, discovery request, or other lawful process when permitted or required by law.
Substance Use Disorder Records
Certain records related to substance use disorder treatment may receive additional protections under federal law, including 42 CFR Part 2.
When AK Wellness receives or maintains records protected by Part 2, we will use and disclose those records only as permitted by applicable law. Certain uses or disclosures may require your written consent, and additional restrictions may apply to the use or disclosure of these records in legal proceedings.
The 2026 HHS model NPP specifically addresses the interaction between HIPAA and federally protected substance-use-disorder records, which is why I would include a concise section like this even though AK Wellness isn't presenting itself as an SUD treatment program.
Our Responsibilities
We are required by law to maintain the privacy and security of your protected health information.
We will notify you as required by law if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in the Notice currently in effect and provide you with a copy upon request.
We will not use or disclose your health information other than as described in this Notice unless you authorize us to do so in writing or another use or disclosure is permitted or required by law.
If you authorize us to use or disclose your information, you may revoke that authorization in writing at any time, except to the extent we have already acted in reliance on it.
Changes to This Notice
We may change the terms of this Notice, and the changes may apply to all health information we maintain about you, including information created or received before the change.
If we make material changes, the revised Notice will be available upon request and will be posted on the AK Wellness website.
Questions or Privacy Concerns
For questions about this Notice, your privacy rights, or AK Wellness's privacy practices, please contact:
Alani Kalfayan, MSN, FNP-C
AK Wellness, PLLC
alani@alanikwellness.com
(424) 257-6494
Effective Date: October 7, 2026