NOTICE OF PRIVACY PRACTICES

Dr. Willoughby & Associates
Effective Date: 02/2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

Dr. Willoughby & Associates is required by law to maintain the privacy of protected health information and to provide individuals with notice of our legal duties and privacy practices.

Nature of Services

Dr. Willoughby & Associates provides independent medical examinations and psychological testing services. These services are evaluative in nature and do not constitute treatment or establish a provider patient treatment relationship.

How We May Use and Disclose Protected Health Information

We may use and disclose protected health information for purposes including:

• Preparation of independent medical examination reports
• Communication with the party who requested the evaluation as authorized
• Legal and administrative proceedings
• Health care operations
• Compliance with federal and state law

Special Protections for Reproductive Health Information

Federal law provides enhanced privacy protections for reproductive health information. Such information may not be used or disclosed for the purpose of investigating or imposing liability related to lawful reproductive health care. Certain disclosures may require additional written attestations in accordance with federal regulations.

Your Rights

You have the right to:

• Request access to protected health information maintained by this practice
• Request amendment of your information
• Request an accounting of certain disclosures
• Request restrictions on certain uses or disclosures
• Request confidential communications

Certain limitations may apply in the context of independent medical examinations.

Our Legal Duties

We are required by law to:

• Maintain the privacy of protected health information
• Provide notice of our privacy practices
• Abide by the terms of this Notice currently in effect
• Notify affected individuals in the event of a breach of unsecured protected health information

Complaints

If you believe your privacy rights have been violated, you may file a complaint with:

Dr. Willoughby & Associates
admin@drwilloughbyandassociates.com
(443) 379-0447

You may also file a complaint with the U.S. Department of Health and Human Services. Filing a complaint will not result in retaliation.