Privacy Policy

Effective Date: October 5, 2026 Website: www.therestoreclinic.com

The Restore Clinic,PLLC respects your privacy and is committed to protecting your personal and health information. This Privacy Policy and HIPAA Notice of Privacy Practices explains how we may collect, use, disclose, and protect information about you, including protected health information, also known as “PHI.”

This notice applies to The Restore Clinic,PLLC, its owner, providers, staff, contractors, and business associates who may assist in providing health care services or supporting clinic operations.

Please review this notice carefully.

We are required by law to maintain the privacy and security of your protected health information. We are also required to provide you with this notice describing our legal duties and privacy practices regarding your health information. We will follow the terms of this notice currently in effect. If we make significant changes to this notice, we will update it on our website and make the revised notice available upon request.

We may collect information from you when you contact us via phone or email, visit our website,  schedule an appointment, submit any kind of intake documentation, communicate with our office, receive care, transmit records of any kind, transfer records to us from outside providers, or use our services.

This information may include:

• Your name, phone number, email address, mailing address, and date of birth
• Family medical history
• Health history, symptoms, medications, lab results, treatment plans, and clinical notes
• Payment, billing, and insurance-related information, if applicable
• Appointment details and communications with our office
• Website usage information, such as IP address, browser type, pages visited, and device information
• Information submitted through online forms, booking tools, chat tools, emails, or patient communication systems

We may use and disclose your health information for the following purposes:

We may use and share your health information to provide, coordinate, or manage your care. This may include sharing information with providers, laboratories, pharmacies, consultants, or other health care professionals involved in your treatment.  

We may use and disclose your information to bill and collect payment for services provided to you. This may include payment processing, invoices, account management, or working with third-party billing vendors.

We may use and disclose your information for business and clinical operations. This may include quality review, staff training, compliance, licensing, audits, legal services, technology support, and improving patient care.

We may use your contact information to send appointment reminders, follow-up messages, treatment-related communications, billing notices, or other administrative updates.

These communications may occur by phone, email, text message, voicemail, or secure patient portal, depending on the contact information you provide and your communication preferences.

We may share your information with third-party service providers, known as business associates, who help us operate our practice. These may include electronic health record vendors, scheduling platforms, billing services, IT providers, marketing platforms, payment processors, laboratories, pharmacies, or secure communication tools. When required by law, we require business associates to protect your information and use it only for permitted purposes.

We may use or disclose your health information without your written authorization when permitted or required by law, including:

• When required by federal, state, or local law
• For public health activities
• To report suspected abuse, neglect, or domestic violence, when required or permitted by law
• For health oversight activities, such as audits or investigations
• For judicial or administrative proceedings, when legally required
• For law enforcement purposes, when permitted by law
• To prevent or lessen a serious threat to health or safety
• For workers’ compensation or similar programs, when applicable
• To coroners, medical examiners, or funeral directors, when legally permitted
• For organ, eye, or tissue donation purposes, when applicable
• For specialized government functions, when required or permitted by law

We will obtain your written authorization before using or disclosing your health information for purposes not otherwise permitted by law.

Your written authorization is generally required for:

• Most uses and disclosures of psychotherapy notes, if applicable
• Marketing communications when required by HIPAA
• Sale of protected health information
• Sharing information with individuals or organizations not involved in your care, unless otherwise permitted by law

You may revoke your authorization in writing at any time. Revoking authorization will not affect actions we already took based on your prior authorization.

You have certain rights regarding your protected health information.

You have the right to inspect and request a copy of your medical records and other health information maintained by us, subject to certain legal limitations. We may charge a reasonable, cost-based fee for copies, mailing, or electronic media when permitted by law.

You have the right to request that we amend or correct information in your medical record if you believe it is inaccurate or incomplete. We may deny your request in certain circumstances, but we will provide a written explanation if we do.

You have the right to ask us to contact you in a specific way or at a specific location. For example, you may ask us to contact you only by phone or only at a certain email address. We will accommodate reasonable requests whenever possible.

You have the right to request limits on how we use or disclose your health information for treatment, payment, or health care operations. We are not always required to agree to your request, except in certain cases where you pay for a service in full out of pocket and request that we not share that information with a health plan.

You have the right to request a list of certain disclosures we have made of your health information. This does not include disclosures made for treatment, payment, health care operations, or disclosures you authorized.

You have the right to receive a paper or electronic copy of this notice at any time.

You have the right to file a complaint if you believe your privacy rights have been violated.

You may contact us directly at:

The Restore Clinic, PLLC, 530 West Jackson St, Suite A, Cookeville, TN 38501

P: 615-488-4172; F: 615-454-9827

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

When you visit www.therestoreclinic.com, we may collect limited technical information to help operate, protect, and improve the website.

This may include:

• Browser type, IP address, page(s) visited, time spent on the website, traffic/referral source, device type, and/or general location based on IP address

We may use cookies, analytics tools, pixels, or similar technologies to understand website performance, improve user experience, and support marketing efforts. You may be able to control cookies through your browser settings. Disabling cookies may affect some website functionality.

If you submit information through our website, contact forms, scheduling forms, or email, we may use that information to respond to your request, schedule appointments, provide information about services, or support your care. 

Please understand that standard email and some website forms may not be fully secure unless specifically provided through a secure, HIPAA-compliant platform. You should avoid submitting highly sensitive medical information through unsecured forms or regular email unless you understand and accept the risk.

For sensitive medical communications, we may direct you to use a secure patient portal or another secure communication method.

If you provide your mobile number, we may contact you by text message for appointment reminders, scheduling, follow-ups, administrative updates, or other practice-related communications.

Text messages may not be fully secure. By providing your mobile number, you acknowledge that text messaging carries some privacy risk. You may request that we stop texting you at any time.

We may send general wellness updates, service announcements, educational content, or promotional communications if you have provided your contact information or opted in to receive communications. You may unsubscribe or opt out of marketing communications at any time.

We will not use or disclose your protected health information for marketing purposes in a way that requires authorization under HIPAA unless we first obtain your written authorization.

If you make a payment, your payment information may be processed by a third-party payment processor. We do not intentionally store full credit card numbers on our website unless supported by a secure payment system. Payment processors may have their own privacy and security practices.

We use reasonable administrative, technical, and physical safeguards to protect your information from unauthorized access, use, disclosure, alteration, or destruction.

These safeguards may include secure systems, access controls, staff training, password protections, encryption where appropriate, vendor agreements, and internal privacy procedures.

No system can be guaranteed 100% secure. However, we take privacy and security seriously and work to protect your information.

If there is a breach of unsecured protected health information that affects you, we will notify you as required by law. We will also notify the U.S. Department of Health and Human Services and, when required, the media or other applicable parties.

Our website and services are not intended for children under the age of 13 without the involvement and consent of a parent or legal guardian. We do not knowingly collect personal information from children through the website without appropriate consent.

Our website may contain links to third-party websites, platforms, or services. We are not responsible for the privacy practices, security, or content of third-party websites.

We encourage you to review the privacy policies of any third-party websites you visit.

We may update this Privacy Policy and HIPAA Notice of Privacy Practices from time to time.

When we update this notice, we will revise the effective date at the top of the page. The updated version will apply to information we already have about you as well as information we receive in the future, unless otherwise stated.

For questions about this Privacy Policy, HIPAA Notice of Privacy Practices, your health information, or your privacy rights, please contact:

The Restore Clinic, PLLC, 530 West Jackson St,  Suite A, Cookeville, TN 38501