HIPAA Notice of Privacy Practices

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.

Our Legal Duty

Triumph Ortho & Spine LLC (“the Practice,” “we,” “us,” or “our”) is required by law to maintain the privacy of your Protected Health Information (“PHI”), to provide you with this Notice describing our legal duties and privacy practices, and to follow the terms of the Notice currently in effect.

How We May Use and Disclose Your PHI Without Your Written Authorization

We may use and disclose PHI for the following purposes without obtaining your authorization:

• Treatment. We may use and share your PHI to provide medical care to you and to coordinate care with other providers, hospitals, imaging centers, pharmacies, physical therapists, and surgical facilities involved in your treatment.
• Payment. We may use and disclose PHI to bill and collect payment from you, your health plan, or other payers, and to verify benefits and obtain prior authorizations.
• Health Care Operations. We may use and disclose PHI for activities such as quality assessment, credentialing, training, accreditation, audits, and general practice administration.
• Appointment reminders, treatment alternatives, and health-related services. We may contact you to remind you of appointments or to share information about treatment options and services that may be relevant to you.
• As required by law. We will disclose PHI when required by federal, state, or local law, including for public health activities, reporting abuse or neglect, health oversight activities, judicial and administrative proceedings, law enforcement purposes, and reporting to coroners, medical examiners, and funeral directors.
• To avert a serious threat to health or safety.
• For specialized government functions, workers’ compensation, and similar purposes permitted by HIPAA.

Uses and Disclosures Requiring Your Written Authorization

Other uses and disclosures of PHI not described above will be made only with your written authorization. In particular, we must obtain your written authorization for:

• Most uses and disclosures of psychotherapy notes;
• Uses and disclosures of PHI for marketing purposes;
• Any sale of PHI.

You may revoke an authorization in writing at any time, except to the extent we have already relied on it.

Your Rights Regarding Your PHI

• Right to inspect and copy. You may request access to your medical and billing records. We will respond within the time period required by law and may charge a reasonable, cost-based fee for copies.
• Right to amend. You may request that we amend PHI we maintain about you if you believe it is incorrect or incomplete. We may deny the request in certain circumstances.
• Right to an accounting of disclosures. You may request a list of certain disclosures of your PHI made by us, generally for the prior six years.
• Right to request restrictions. You may request restrictions on certain uses or disclosures. We are not required to agree, except that we must agree to a request to restrict disclosure of PHI to a health plan if the disclosure is for payment or health care operations and the PHI relates solely to a service you paid for out of pocket in full.
• Right to request confidential communications. You may request that we contact you at a specific address or phone number.
• Right to a paper copy of this Notice. You may request a paper copy at any time, even if you have agreed to receive it electronically.
• Right to be notified of a breach of unsecured PHI.

To exercise any of these rights, submit a written request to the Privacy Officer at the address below.

Right to Complain

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be retaliated against for filing a complaint.

• To complain to the Practice: Contact the Privacy Officer at the address or email below.
• To complain to HHS: File electronically at hhs.gov/ocr/complaints or call 1-800-368-1019.

Changes to This Notice

We reserve the right to change the terms of this Notice and to make the new Notice effective for all PHI we maintain. The current Notice will be posted in our office and on our Website, with the effective date noted at the bottom.

Contact — Privacy Officer

[PRIVACY OFFICER NAME], Privacy Officer
Triumph Ortho & Spine LLC
2999 NE 191st St, Suite 300
Miami, FL 33180
(877) 215-7246

Effective date: May 23, 2026.