HIPAA HIPAA Notice This notice describes how health information about you is used and disclosed in this office and how your privacy is protected. All health information, notes, test results, letters, emails, phone calls and any other method of communication between this office and you in regard to your health is kept private by this office. All information about you is stored in a secured location and is never given out to a third party unless there is a specific request by you to do so. We value your relationship and respect your right to privacy. Sincerely, Beth Colon, M.S., BCHN I have read the above notice and have had an opportunity to ask questions in regard to this notice. I understand that all confidential information collected by Holistic Nutrition Services LLC will not be shared without my prior authorization and that every effort will be made to protect my privacy Your Name (required) Your Email (required) Date (required) I understand that by signing my name above and clicking "Send" below, I am electronically signing this document.