PRIVACY POLICY
Last Updated: August 2026
Holistic Origin Her WellnessTM
PURPOSE & SCOPE
Holistic Origin Her WellnessTM (“Practice,” “we,” “our,” or “us”) respects the privacy of visitors, prospective patients, and
patients. This Privacy Policy explains how personal information may be collected, used, disclosed, stored, and protected when
you visit our website, contact the Practice, use online forms or scheduling features, or interact with other non-clinical digital
services.
If information you provide becomes part of your patient record or otherwise constitutes protected health information under
HIPAA, the Notice of Privacy Practices and applicable health-privacy laws govern that information.
ABOUT OUR PRACTICE
Holistic Origin Her WellnessTM is a telehealth-based women’s health practice providing personalized consultation services to
adult women age 21 and older who are physically located in a state where the provider is authorized to provide the applicable
services.
Consultation areas may include preventive and metabolic wellness, reproductive and fertility planning, preconception wellness,
menopause and midlife wellness, nutrition and lifestyle guidance, and healthy-aging priorities.
The Practice does not provide ongoing medication or prescription management as part of its consultation model.
INFORMATION WE MAY COLLECT
Depending on how you interact with us, we may collect information that you provide directly, information generated through
your use of our website or services, and information received from authorized third parties.
PERSONAL & CONTACT INFORMATION
• Name
• Date of birth when needed for patient-related services
• Mailing or billing address
• Telephone number
• Email address
• Emergency contact information when collected for patient services
• Information submitted through website forms, scheduling tools, or other communications
HEALTH & CONSULTATION INFORMATION
When you become a patient or submit information for consultation services, we may collect health-related information such as:
• Health and medical history
• Medication and supplement history
• Allergies
• Laboratory results and imaging reports you provide or authorize us to receive
• Health questionnaires and intake information
• Consultation notes and recommendations
• Patient-portal and healthcare communications
Health information that is protected by HIPAA is handled in accordance with our Notice of Privacy Practices.
FINANCIAL INFORMATION
For cash-pay consultation services, we may collect or process information necessary for payment and financial administration,
such as:
• Payment transaction information
• Billing contact information
• Payment status and billing records
• Refund, cancellation, or payment-dispute information
Payment card information may be processed by an authorized payment processor. We do not represent that the Practice
directly stores full payment-card numbers unless that is actually part of our payment system.
This Privacy Policy is separate from our Notice of Privacy Practices (NPP). The NPP governs how protected health
information is used and disclosed when HIPAA applies.
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WEBSITE & DEVICE INFORMATION
When you visit our website, certain information may be collected automatically by our website, hosting provider, security tools,
or analytics technologies, depending on how the site is configured. This may include:
• IP address
• Browser and device information
• Operating system
• Pages viewed and links used
• Date, time, and duration of visits
• Referring website or source
• Approximate location derived from technical information
• Cookie, analytics, and similar technology data
HOW WE MAY USE INFORMATION
We may use information as reasonably necessary to:
• Operate, maintain, secure, and improve the website
• Respond to questions and requests
• Schedule and administer consultation services
• Provide consultation services when applicable
• Process cash-pay consultation payments and refunds
• Communicate about appointments and Practice operations
• Maintain appropriate patient and business records
• Prevent fraud, misuse, security incidents, or unauthorized activity
• Comply with legal, regulatory, accounting, and professional obligations
• Evaluate website performance and user experience
We do not use this Privacy Policy to expand uses or disclosures of protected health information beyond what is permitted by
our Notice of Privacy Practices and applicable law.
HIPAA & PROTECTED HEALTH INFORMATION
When Holistic Origin Her WellnessTM creates, receives, maintains, or transmits protected health information in circumstances
governed by HIPAA, that information is handled in accordance with applicable federal and state health-privacy laws and our
Notice of Privacy Practices.
The NPP explains permitted uses and disclosures of protected health information, patient privacy rights, the Practice’s
responsibilities, and how to submit a privacy complaint.
The current NPP is available from the Practice and should be posted on the Practice website when required by law.
ELECTRONIC HEALTH RECORD, TELEHEALTH & PATIENT PORTAL
Holistic Origin Her WellnessTM uses healthcare technology to support electronic health records, telehealth consultations,
patient-portal communication, documentation, scheduling, and Practice operations.
Information submitted through a patient portal or collected as part of consultation services may become part of the patient’s
healthcare record.
Reasonable administrative, technical, and physical safeguards are used to protect information. No electronic system,
transmission method, or storage system can guarantee absolute security.
PATIENT PORTAL COMMUNICATION
The patient portal is intended for administrative communication and non-urgent matters related to consultation services.
Portal messages are not continuously monitored and do not constitute continuous health monitoring or unlimited access to the
provider.
AI-ASSISTED DOCUMENTATION & TECHNOLOGY
Holistic Origin Her WellnessTM may use technology, including AI-assisted documentation tools, to support documentation and
administrative efficiency when permitted by applicable law and Practice policy.
The provider remains responsible for reviewing and approving clinical documentation and exercising independent professional
judgment.
Do not use the patient portal, website forms, email, or other routine Practice communications for medical
emergencies or conditions requiring immediate attention.
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When a technology provider receives or maintains protected health information on behalf of the Practice and qualifies as a
HIPAA business associate, appropriate contractual safeguards are used as required by law.
THIRD-PARTY SERVICE PROVIDERS
We may use third-party service providers to support Practice and website operations. Depending on our current technology
configuration, these services may include:
• Electronic health record and patient-portal technology
• Telehealth technology
• Scheduling services
• Payment processing
• Website hosting and security
• Email and Practice communications
• Analytics or website-performance tools
• Professional, legal, accounting, or compliance services
Third parties may receive only the information reasonably necessary for their functions, subject to applicable contracts and
law. When a vendor qualifies as a HIPAA business associate, a Business Associate Agreement or other required safeguard is
used.
Third-party websites and services may maintain their own privacy policies and terms. We encourage users to review those
policies before providing information directly to a third party.
COOKIES & SIMILAR TECHNOLOGIES
Our website may use cookies and similar technologies for essential website functions, security, preferences, performance, or
analytics, depending on the technologies currently enabled.
Your browser may allow you to block or delete cookies. Disabling cookies may affect some website functions.
If the Practice uses analytics, advertising, tracking, or similar technologies that require additional notice or consent under
applicable law, the Practice will implement appropriate disclosures or controls based on the actual website configuration.
SENSITIVE HEALTH INFORMATION & WEBSITE TRACKING
The Practice seeks to minimize unnecessary collection of health information through public website tools. Patient health
information should generally be submitted through Practice-approved secure healthcare channels.
The Practice will evaluate website tracking technologies and their configuration before using them on pages that may involve
protected or sensitive health information.
HOW INFORMATION MAY BE DISCLOSED
We may disclose personal information when reasonably necessary to:
• Service providers supporting authorized Practice or website functions
• Professional advisors such as legal, accounting, compliance, or security professionals
• Government, regulatory, law-enforcement, or other entities when required or permitted by law
• Protect the rights, safety, security, or property of patients, users, the Practice, or others when legally permitted
• Complete a lawful business reorganization or transfer, subject to applicable privacy obligations
Protected health information is disclosed only as permitted by the Notice of Privacy Practices and applicable law.
SALE OF PERSONAL INFORMATION
Holistic Origin Her WellnessTM does not sell protected health information.
The Practice does not intend to sell personal information collected through its website. If Practice activities change in a
manner that creates additional rights or disclosures under applicable privacy law, this policy and any required notices or
controls will be updated.
DATA SECURITY
We use reasonable administrative, technical, and physical safeguards designed to protect personal information against
unauthorized access, use, disclosure, alteration, or destruction.
Security measures may include access controls, authentication, secure technology platforms, vendor safeguards, workforce
practices, and other measures appropriate to the information involved.
Despite reasonable safeguards, no website, electronic communication, or information system can be guaranteed to be
completely secure.
Do not submit detailed medical information through a general website contact form unless the form is specifically
designated and secured for that purpose.
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DATA RETENTION
We retain information for as long as reasonably necessary for the purposes for which it was collected and to meet applicable
healthcare-record, legal, regulatory, accounting, security, and operational requirements.
Patient records are retained in accordance with applicable federal and state record-retention requirements.
YOUR PRIVACY CHOICES & RIGHTS
Depending on the type of information involved and applicable law, you may have rights or choices regarding your information.
• Request access to or correction of certain personal information
• Manage browser cookies and similar technologies
• Unsubscribe from non-essential marketing communications if offered
• Ask questions about how your information is handled
• Exercise HIPAA rights described in the Notice of Privacy Practices when protected health information is involved
Rights relating to protected health information should be exercised as described in the Notice of Privacy Practices.
EMAIL & ELECTRONIC COMMUNICATION
Email and general website communications may not provide the same privacy protections as a secure patient portal. Please
avoid sending sensitive medical information through ordinary email unless instructed to do so through an approved process.
Administrative emails may be used for scheduling, confirmations, Practice notices, and other operational communications.
MINORS
Holistic Origin Her WellnessTM provides consultation services to adults age 21 and older. Consultation services are not
intended for minors.
The public website is not designed to knowingly collect personal information from children for the purpose of providing
consultation services.
THIRD-PARTY LINKS
Our website may contain links to external websites or resources. We are not responsible for the privacy practices, content,
security, or terms of unaffiliated third-party websites.
Visiting an external website is subject to that website’s own privacy policy and terms.
CHANGES TO THIS PRIVACY POLICY
We may update this Privacy Policy from time to time to reflect changes in Practice operations, technology, legal requirements,
or privacy practices.
The current version and last-updated date will be posted on the website. Material changes will be communicated when
required by applicable law.
CONTACT INFORMATION
Holistic Origin Her WellnessTM
Privacy Contact/Official: __________________________________
Email: _________________________________________________
Telephone: ______________________________________________
Website: www.holisticoriginherwellness.com
For privacy-related questions, requests, or concerns, contact the Practice using the information above.
ACKNOWLEDGMENT
When this Privacy Policy is presented as part of patient onboarding, a signature or electronic acknowledgment may be used to
document that the policy was made available. Acknowledgment of this Privacy Policy does not replace acknowledgment of the
Notice of Privacy Practices and does not authorize uses or disclosures of protected health information beyond those permitted
by law.
Patient Name: _______________________________________________________
Patient Signature: _______________________________________________________
Date: _________________________
Holistic Origin Her WellnessTM