Effective Date: November 10, 2025

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

Who we are
Mobile Hearing Solutions is a HIPAA-covered mobile hearing-care provider serving DFW and surrounding communities. This Notice applies to our workforce and to Business Associates operating under Business Associate Agreements (BAAs).

Our responsibilities

• Maintain the privacy and security of your Protected Health Information (PHI)

• Notify you following any breach of unsecured PHI

• Follow the duties and practices in this Notice and provide a copy on request

• Not use or share your information other than as described here unless you authorize us in writing (you may revoke authorization at any time)

How we may use/disclose PHI without authorization

• Treatment: provide/coordinate your care, including telehealth, in-home services, and referrals

• Payment: verify eligibility and benefits, obtain authorizations, bill and receive payment from you/insurer

• Health care operations: quality assessment, training, accreditation, audits, legal services, administration

• As required by law: public health, oversight, law enforcement, court orders, mandatory reporting as applicable

• To avert a serious threat: prevent/lessen a serious and imminent threat to health/safety

• Business Associates: vendors performing services for us under BAAs (secure forms, scheduling, CRM, hosting, telehealth)

Other uses/disclosures require your authorization
We will obtain your written permission for uses not described above, including most marketing communications, sale of PHI, and most sharing of psychotherapy notes (if applicable). You may revoke authorization at any time in writing.

Your rights

• Inspect & copy your medical record/PHI (electronic or paper; reasonable cost-based fee may apply; usually within 30 days)

• Amend your record if you believe it’s inaccurate or incomplete (we may deny in certain cases; we’ll explain in writing)

• Accounting of disclosures for the past six years (certain exceptions apply)

• Request restrictions on uses/disclosures for treatment, payment, or operations (we may deny; if you pay out-of-pocket in full, you can request we not share that item/service with your insurer)

• Request confidential communications (e.g., use a specific phone or email)

• Get a paper copy of this Notice at any time

• Choose someone to act for you (legal guardian/POA)

Your choices
Tell us your preferences for: sharing with family/friends involved in care, disaster relief, or inclusion in any directory (if maintained). If you cannot tell us, we may share in your best interest when appropriate.

Complaints
Email Ashley.bukowski@mobilehsolutions.com or call (469)613-4327. You may also file a complaint with the U.S. Department of Health & Human Services, Office for Civil Rights (OCR). We will not retaliate.

Changes to this Notice
We may change this Notice and the changes apply to all information we maintain. The current Notice will be available on our website and upon request.

Contact (Privacy Officer/Contact):
Mobile Hearing Solutions — Ashley.bukowski@mobilehsolutions.com — (469)613-4327