WellForm MD is committed to protecting your privacy and ensuring the confidentiality and security of your health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and other applicable laws. This Privacy Policy explains how we collect, use, disclose, and safeguard your information across all platforms, including online, in-person, and during treatment.

1. Information We Collect

We collect and maintain personal and health-related information to provide wellness and medical services. This may include:

  • Personal Information: Name, date of birth, contact details, billing information, and identification.
  • Medical Information: Health history, treatment records, physician notes, and prescriptions.
  • Photographic and Visual Data: Images taken for medical or wellness purposes, including body composition analysis and progress tracking.
  • Digital and Website Data: Information collected through our website, appointment scheduling systems, and online forms, including IP addresses and usage analytics.

2. Use and Disclosure of Your Information

Your Protected Health Information (PHI) may be used and disclosed as permitted by law, including for the following purposes:

  • Treatment: Sharing necessary medical information with healthcare providers involved in your care.
  • Healthcare Operations: Administrative tasks, quality improvement, staff training, and facility management.
  • Payment Processing: Billing, insurance claims, and other payment-related transactions.
  • Legal Compliance: Responding to legal requirements, subpoenas, or public health reporting obligations.
  • Marketing Communications: We may contact you about wellness services or promotions with your consent. You may opt out at any time.

Your Rights to Restrict Disclosure

You may request limitations on how your information is shared. To request restrictions, please submit a written request to WellForm MD.

3. Data Retention and Security

WellForm MD securely retains client records as required by law.

  • Retention Period: Records will be maintained for a minimum of 10 years unless a longer period is required by law or requested by the client.
  • Security Measures: We implement administrative, technical, and physical safeguards to protect your data from unauthorized access, disclosure, or alteration.

4. Your Rights Under HIPAA

Under HIPAA, you have the right to:

  • Access Your Records: Obtain a copy of your medical records, including in printed form upon request.
  • Request Corrections: Ask for corrections to inaccurate or incomplete information.
  • Receive an Accounting of Disclosures: Request a record of who has accessed your health information.
  • Request Restrictions: Limit the sharing of your information under certain circumstances.
  • Confidential Communications: Request communication through specific methods (e.g., email instead of mail).
  • File a Complaint: If you believe your privacy rights have been violated, you may file a complaint with WellForm MD or the U.S. Department of Health & Human Services.

5. Updates to This Policy

We may update this Privacy Policy periodically. Changes will be posted on our website with an updated effective date. Continued use of our services after policy updates constitutes acceptance of the revised terms.

6. Contact Information

If you have questions, concerns, or wish to exercise your rights, please contact:

WellForm MD
📧 Contact Form
📞 Phone: 515-724-9517
📍 Address: 2675 N Ankeny Blvd, #113, Ankeny, IA 50023