Last Updated: December 10, 2025PRIVACY POLICY
This notice describes the practices of Sculpt Aesthetics (the “Practice”) and its staff with respect to your protected health information maintained by the practice. This notice will tell you about the ways in which we may use and disclose medical information about you. It also describes your rights and certain obligations we have regarding the use and disclosure of medical information. Please review this Notice carefully.1. Your Health Information Rights
Although your health record is the physical property of the Practice, the information belongs to you. You have the right to:
Request a restriction on certain uses and disclosures of your information for treatment, payment, and health care operations. However, we are not required by law to agree to a requested restriction, unless it relates to a restriction on disclosures to your health insurer regarding health care items or services for which you have paid out of pocket and in full.
Obtain a paper copy of this notice from Sculpt Aesthetics.
Inspect and/or get an electronic or paper copy of your medical record. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Request that we amend your health record as provided by law. We will notify you if we are unable to grant your request to amend your health record within 60 days of your request.
Obtain an accounting of disclosures of your health information as provided by law. We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Request communication of your health information by alternative means or at alternative locations. We will accommodate reasonable requests.
You may exercise your rights set forth in this notice by providing a written request to Sculpt Aesthetics, 1230 N 1st Street, Hamilton, MT 59840.
2. Uses and Disclosures of Medical Information That Do Not Require Your Authorization
The following categories describe different ways that we may use and disclose medical information without your authorization. We will explain what we mean for each category of uses or disclosures, but not every use or disclosure in a category will be listed. However, all the ways we are permitted to use and disclose information without your authorization should fall within one of the categories.
Treatment: We may disclose medical information about you to doctors, nurses, technicians, and other personnel involved in your care.
Billing: We may use and share your health information to bill and receive payment for services we provide.
Health Care Operations: We may use the information in your health record to assess care and outcomes and to improve the quality and effectiveness of our services.
No Sharing of Mobile Details or Personally Identifiable Information: We will not share your mobile details or any personally identifiable information with third parties or affiliates for marketing or promotional purposes.
3. Our Responsibilities
In addition to the responsibilities set forth above, we are also required to:
Maintain the privacy and security of your health information.
Provide notice of any unauthorized acquisition, access, use, or disclosure of your protected health information, to the extent it was not otherwise secured.
Abide by the terms of this Notice.
Notify you if we are unable to agree to a requested restriction on certain uses and disclosures.
We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain, including information created or received before the change. Should our information practices change, we are not required to notify you, but we will have the revised notice available upon your request at Sculpt Aesthetics.
4. When We Need Your Written Authorization
We will not use or disclose your health information without your written authorization, except as described in this notice. Additional circumstances that might require your additional written authorization are not common, but an example would be uses and disclosures for marketing purposes.5. Contact Us
If you have questions or would like additional information, you may contact Sculpt Aesthetics at: Phone: (406) 961-9700
If you believe your privacy rights have been violated, you can send a complaint to Sculpt Aesthetics at 1230 N 1st Street, Hamilton, MT 59840. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints. There will be no retaliation for filing a complaint.
This notice is effective on the following date: January 19, 2023.
We may change our policies and this notice at any time and have those revised policies apply to all the protected health information we maintain. If or when we change our notice, we will post the new notice at the office of each practice location where it can be seen and on our website.