Notice of Privacy Practices

David H. Nielson, M.D.
Notice of Privacy Practices
Effective Date: February 19, 2026

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

If you have any questions about this notice, please contact the office of Dr. David H. Nielson at 210-490-7464.

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, a plan for future care or treatment, and billing-related information. This notice applies to all of the records of your care generated by our office, whether made by office staff or your personal doctor.

Our Responsibilities

We are required by law to maintain the privacy of your health information and provide you a description of our privacy practices. We will abide by the terms of this notice.

Uses and Disclosures

How we may use and disclose information about you.

Mobile Information: “No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. All the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties."

For Treatment:   We may use health information about you to provide you treatment or services. We may disclose health information about you to doctors, nurses, technicians, or other hospital personnel who are involved in taking care of you at the hospital. For example: the nursing staff at the hospital may need to know of your allergies to certain medications in order to care for you properly. We may share health information about you in order to coordinate the different things you may need, such as prescriptions, lab work, and x-rays. We may also provide your physician or a subsequent healthcare provider with copies of various reports that should assist him or her in treating you once you're discharged from Dr. David Nielson's care.

For Payment:  We may use and disclose health information about your treatment and services to bill and collect payment from you, your insurance company or a third party payer. For example: We may need to give your insurance company information about your surgery so they will pay us or reimburse you for the treatment. We may also tell your health plan about treatment you are going to receive to determine whether your plan will cover it.

For Health Care Operations:  Members of the medical staff and/or quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. The results will then be used to continually improve the quality of care for all patients we serve. For example: We may combine health information about many patients to evaluate the need for better services or treatment. When disclosing information, primarily to check on your health status, and billing/collections efforts, we may leave messages on your answering machine/voice mail or may send you email. We cannot guarantee confidentiality with email correspondence.

Law Enforcement/Legal Proceedings:  We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

State-Specific Requirements:  Many states have requirements for reporting including population-based activities relating to improving health or reducing health care costs. Some states have separate privacy laws that may apply additional legal requirements. If the state privacy laws are more stringent than federal privacy laws, the state law preempts the federal law.

Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that compiled it, you have the RIGHT to:

Inspect and Copy: You have the right to inspect and obtain a copy of the health information that may be used to make decisions about your care. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to health information, you may request that the denial be reviewed. Another licensed health care professional chosen by our office will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

Amend:  If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by our office.

We may deny your request for an amendment and if this occurs, you will be notified of the reason for the denial.

An Accounting of Disclosures:  You have the right to request an accounting of disclosures. This is a list of certain disclosures we make of your health information for purposes other than treatment, payment or health care operations where an authorization was not required.

Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had.

We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example: You may ask that we contact you at work instead of your home. Our office will grant reasonable requests for confidential communications at alternative locations and/or via alternative means only if the request is submitted in writing and the written request includes a mailing address where the individual will receive bills for services rendered by our office and related correspondence regarding payment for services. Please realize, we reserve the right to contact you by other means, such as email, and at other locations if you fail to respond to any communication from us that requires a response. We will notify you in accordance with your original request prior to attempting to contact you by other means or at another location.

A Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.

You may print or view a copy of the notice by clicking on the Notice of Privacy Practices Link on Dr. David Nielson's website, www.Hyperhidrosis-USA.com

To exercise any of your rights, please obtain the required forms from our office and submit your request in writing.

Changes to This Notice

We reserve the right to change this notice and the revised or changed notice will be effective for information we already have about you as well as any information we receive in the future.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our office by contacting us at 210-490-7464. All complaints must be submitted in writing.

You will not be penalized for filing a complaint.

OTHER USES OF HEALTH INFORMATION
Other uses and disclosures of health information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

David H. Nielson, M.D.
210-490-7464

Acknowledgement of Review of Notice of Privacy Practices

I have reviewed this office’s Notice of Privacy Practices, which explains how my medical information will be used and disclosed. I understand that I am entitled to receive a copy of this document.

___________________________________________________ __________________________
Signature of Patient or Personal Representative                                                    Date

___________________________________________________
Written Name of Patient or Personal Representative

____________________________________________________
Description of Personal Representative’s Authority

NOTE TO PATIENT: IMPORTANT! PLEASE READ. As mandated by Federal Privacy Laws, as of April 14, 2004, we must have the patient’s permission to exchange personal information. Please sign and fax this Notice of Privacy Practices Form to Dr. Nielson’s office at (210)-479-2506 (FAX). We must have this signed form BEFORE we can proceed with processing your personal information.                              Updated:  11/30/09