Effective date: August 2026
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
You may request a paper or electronic copy of this notice at any time. A PDF version is available for download: Download Notice of Privacy Practices (PDF) →
The Acknowledgment of Receipt form will be provided to you at your first appointment through the SigmaMD patient portal.
You have the right to:
You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. 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.
You can ask us to correct health information about you that you think is incorrect or incomplete. We may say "no" to your request, but we'll tell you why in writing within 60 days.
You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say "yes" to all reasonable requests.
You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say "no" if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say "yes" unless a law requires us to share that information.
You can ask for a list (accounting) of the times we've shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). 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.
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
You can complain if you feel we have violated your rights by contacting us using the information below. 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/. We will not retaliate against you for filing a complaint.
You have some choices in the way that we use and share information as we tell family and friends about your condition, provide disaster relief, provide mental health care, market our services, and raise funds.
In the following cases, you have both the right and choice to tell us to:
If you are not able to tell us your preference — for example if you are unconscious — we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
Fundraising: We may contact you for fundraising efforts, but you can tell us not to contact you again.
We typically use or share your health information in the following ways:
We can use your health information and share it with other professionals who are treating you.
We use health information about you to manage your treatment and services.
We give information about you to your health insurance plan so it will pay for your services. (Note: Metis Midlife Medicine is a cash-pay practice and does not bill insurance directly; however, we may provide superbills for out-of-network reimbursement.)
We can share health information about you for certain situations such as preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone's health or safety.
We can use or share your information for health research.
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we're complying with federal privacy law. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
We can share health information about you with organ procurement organizations.
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
We can use or share health information about you for workers' compensation claims, for law enforcement purposes or with a law enforcement official, with health oversight agencies for activities authorized by law, and for special government functions such as military, national security, and presidential protective services.
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
This Notice of Privacy Practices applies to Metis Midlife Medicine, PLLC.
Questions about this document? Contact us at info@metismidlife.com or by mail at Metis Midlife Medicine, PLLC, 9975 Wadsworth Pkwy, Unit K2-162, Westminster, CO 80022.