Overview

Please review our Practice Policies, HIPAA Notice, Consent to Treat, and Telehealth Agreement. This document outlines how Hygeia Wellness provides services, protects your health information, and obtains your consent for care. By continuing with services, you confirm that you have read, understood, and agreed to these terms.

Practice Policies‍

Eligibility for Services

Hygeia Wellness provides services only to individuals 18 years or older. By engaging in services, you confirm that you meet this requirement.

Session Length

All nutrition counseling sessions are a minimum of 53 minutes.

• Late arrival may shorten your session
• Leaving early does not reduce the session fee

No-Show & Late Cancellation Policy

Appointments are reserved specifically for you.

• A minimum of 24 hours’ notice is required for cancellations
• Missed or late-cancelled sessions result in a $100 fee
• This fee is not covered by insurance
• The fee will be charged to your saved payment method

Telehealth Environment Requirements

All sessions are conducted via secure telehealth. You agree to attend sessions:

• In a quiet, private space
• Free from distractions
• Not while driving or operating machinery

Sessions may be ended if the environment is inappropriate or behavior is unprofessional.

Communication Between Sessions

Providers are only available during scheduled appointments. For non-urgent communication, communicate with your provider via email. Providers do not offer ongoing clinical advice outside sessions.

PERSONAL HEALTH INFORMATION

To keep your personal health information secure, please send all sensitive details—like completed forms and file uploads—through our HIPAA-compliant portal, Healthie. We’ll also use Healthie for our telehealth sessions.

• Forms and questionnaires
• File uploads
• Care plans
• Telehealth sessions

Please avoid sharing sensitive information via unsecured channels, including email.

Termination of Services

Services may be discontinued if:

• Treatment is no longer appropriate
• Payment is not completed
• Repeated missed appointments
• Boundaries are not respected

Missing three consecutive sessions may result in termination.

Insurance & Payment Authorization

By using our services, you authorize us to:

• Charge your card for services
• Charge cancellation fees
• Submit insurance claims

You are responsible for:

• Copays
• Deductibles
• Coinsurance
• Non-covered services

Unpaid balances after 14 days may be sent to collections.

HIPAA Notice (Protected Health Information)

Your Privacy Matters

Hygeia Wellness is committed to protecting your Protected Health Information (PHI). We maintain records to:

• Provide quality care
• Coordinate treatment
• Meet legal requirements

Our Responsibilities

We are required to:

• Maintain privacy of your data
• Provide this notice
• Follow stated policies
• Notify you of any data breaches

How We Use Your Information

Treatment: To coordinate your care with providers.

Payment: To process billing and insurance claims.

Healthcare Operations: To improve services, training, and administration.

When Authorization Is Required

We require your permission to share information outside your care team. We do not sell health information.

Legal Disclosures

We may share data when required by law, such as:

• Abuse or neglect reporting
• Court orders
• Public health requirements

Your Rights

You have the right to:

• Access your records
• Request corrections
• Request restricted use
• Request confidential communication
• Receive a copy of this notice

Consent to Treat

By using our services, you agree to receive nutrition counseling and health education. Services may include:

• Dietary guidance
• Lifestyle support
• Nutrition education

Important notes:

• These services do not replace medical care
• Results are not guaranteed
• Recommendations are based on professional judgment

Telehealth Consent

All services are provided through secure video consultations.

Risks may include:

• Internet issues
• Technical disruptions
• Limited clarity

Benefits include:

• Convenience
• Reduced travel
• Better access to care

Telehealth is not for emergencies. Call emergency services if needed.

By participating, you confirm:

• You understand telehealth
• You consent to video consultations
• You will use the approved platform

Acknowledgement

By continuing, you confirm that you:

• Have read and understood this document
• Agree to all policies
• Understand your HIPAA rights
• Consent to treatment
• Consent to telehealth services