Board-certified clinicians · One dedicated provider · Discreet telehealth in Colorado · (303) 276-5634
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.
Delta Wellness Collective PLLC ("Delta Wellness Collective," "we," "us," or "our") is a telehealth-only men's health practice registered in the State of Colorado. We are a covered entity under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and are required by law to maintain the privacy of your Protected Health Information (PHI).
The following describes the ways we may use and disclose your PHI. Not every use or disclosure in a category will be listed, but all of the ways we are permitted or required to use and disclose PHI will fall within one of these categories.
For any purpose not listed above, we will only use or disclose your PHI with your written authorization. You may revoke an authorization at any time in writing, except to the extent we have already acted in reliance on it. The following always require your authorization:
You have the following rights regarding the PHI we maintain about you. To exercise any of these rights, contact us using the information in Section 5. We will respond to all requests within 30 days (with a possible 30-day extension for complex requests, with written notice).
You have the right to inspect and obtain a copy of PHI contained in your medical and billing records for as long as we maintain those records. A reasonable fee may apply to cover copying or electronic access costs.
How to request: Submit a written request to delta@deltawellnessco.com or through the OptiMantra patient portal. Please specify what records you are requesting and your preferred format (electronic or paper). We will respond within 30 days.
We may deny access in limited circumstances (e.g., if access is reasonably likely to endanger you or another person). If denied, you may request an independent review by a licensed healthcare professional designated by us.
You have the right to request that we amend PHI in your medical or billing records if you believe it is inaccurate or incomplete.
How to request: Submit a written request to delta@deltawellnessco.com identifying the specific information you want amended and the reason for the amendment. We may deny your request if we determine the information is accurate and complete, was not created by us, is not part of records we maintain, or is not information you would have the right to inspect.
You have the right to request an accounting of certain disclosures of your PHI made by us during the six years prior to your request. This accounting does not include disclosures made for treatment, payment, or healthcare operations, or disclosures made with your authorization.
How to request: Submit a written request to delta@deltawellnessco.com specifying the time period (up to 6 years). The first accounting in any 12-month period is free. We may charge a reasonable fee for subsequent requests in the same 12-month period — we will notify you of the cost before proceeding.
You may request restrictions on how we use or disclose your PHI for treatment, payment, or healthcare operations, or to persons involved in your care. We are not required to agree to your request unless the restriction is to limit disclosure to a health plan for payment or operations purposes, the disclosure is not required by law, and you (or someone on your behalf) have paid for the service out of pocket in full. As a cash-pay practice, this right is particularly relevant to our patients.
How to request: Submit a written request to delta@deltawellnessco.com specifying what you want restricted and to whom. We will notify you whether we can accommodate your request.
You have the right to request that we communicate your PHI to you by alternative means or at an alternative location (e.g., a specific phone number or email address rather than your primary contact on file).
How to request: Submit a written request to delta@deltawellnessco.com or through the OptiMantra patient portal specifying your preferred method and location of communication. We will accommodate reasonable requests.
You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
How to request: Email delta@deltawellnessco.com or call (303) 276-5634 to request a paper copy. We will mail it to your address on file.
In the event of a breach of your unsecured PHI, we are required by law to notify you without unreasonable delay and within 60 days of discovering the breach. Notification will be provided via the contact information you have on file with us.
You have the right to opt out of receiving marketing communications, appointment reminders by a specific channel, or other non-essential communications. Opting out of marketing communications will not affect your ability to receive care-related communications.
How to request: Email privacy@deltawellnessco.com with "Opt-Out Request" in the subject line and specify what type of communications you want to stop.
If you believe that Delta Wellness Collective has violated your privacy rights, or if you disagree with a decision we made about access to your PHI, you have the right to file a complaint. We will not retaliate against you in any way for filing a complaint.
We take all privacy complaints seriously and will investigate promptly.
Please include your full name, contact information, a description of the concern, and the approximate date of the issue. We will acknowledge your complaint within 5 business days and provide a substantive response within 30 days.
You may also file a complaint with the Office for Civil Rights (OCR) of the U.S. Department of Health and Human Services (HHS), which enforces HIPAA privacy rules. You may file a complaint:
Complaints to OCR must be filed within 180 days of when you knew or should have known of the alleged violation. OCR may extend this period for good cause.
For all privacy-related questions, rights requests, or complaints, contact us at:
This Notice of Privacy Practices is posted on deltawellnessco.com and is available in your OptiMantra patient portal. A paper copy is available upon request. This Notice complies with HIPAA (45 CFR Parts 160 and 164) and applicable Colorado state law.
Our privacy team can walk you through any of the rights described above. Email privacy@deltawellnessco.com or call us during business hours.