Effective Date: September 18, 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.

Shiloh Health LLC (Shiloh Health, we, us, or our) is committed to protecting the privacy of your Protected Health Information (PHI). This Notice describes our legal duties and privacy practices with respect to PHI, and your rights regarding that information, in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations at 45 CFR Parts 160 and 164.

Our Responsibilities

We are required by law to:

• Maintain the privacy of your PHI;
• Provide you with this Notice describing our legal duties and privacy practices regarding PHI;
• Notify you if a breach of your unsecured PHI occurs;
• Abide by the terms of the Notice currently in effect.

How We May Use and Disclose Your PHI

For Treatment. We may use and disclose your PHI to provide, coordinate, or manage your health care and related services, including consultation between providers involved in your care.

For Payment. We may use and disclose your PHI to obtain payment for services we provide, including billing, claims management, and collection activities with insurers or other payors.

For Health Care Operations. We may use and disclose your PHI for activities such as quality assessment, staff training, licensing, and general practice management.

Other Permitted or Required Uses and Disclosures Without Your Authorization

• As required by federal, state, or local law;
• For public health activities, such as disease prevention or control;
• For health oversight activities authorized by law;
• In response to a court order, subpoena, or discovery request, under certain conditions;
• For limited law enforcement purposes, such as reporting certain wounds or responding to a warrant;
• To avert a serious and imminent threat to health or safety;
• As authorized by workers compensation laws;
• To coroners, medical examiners, and funeral directors as necessary for their duties.

Uses and Disclosures Requiring Your Written Authorization

Uses and disclosures of PHI not described above, including most uses and disclosures of psychotherapy notes where applicable, uses for marketing purposes, and disclosures that constitute a sale of PHI, will be made only with your written authorization. You may revoke an authorization at any time in writing, except to the extent we have already acted in reliance on it.

Your Rights Regarding Your PHI

• Right to Inspect and Copy. You may request to inspect and obtain a copy of your PHI, with limited exceptions.
• Right to Request Amendment. You may request that we amend your PHI if you believe it is incorrect or incomplete.
• Right to an Accounting of Disclosures. You may request a list of certain disclosures we made of your PHI in the six years prior to your request.
• Right to Request Restrictions. You may request restrictions on certain uses and disclosures of your PHI, including disclosures to family members involved in your care.
• Right to Request Confidential Communications. You may request that we communicate with you about medical matters by alternative means or at an alternative location.
• Right to a Paper Copy of This Notice. You may request a paper copy of this Notice at any time, even if you agreed to receive it electronically.
• Right to Be Notified of a Breach. You have the right to be notified if a breach of your unsecured PHI occurs.

Security of Your PHI

PHI transmitted through our website, including appointment requests and patient communications, is encrypted in transit using Secure Socket Layer (SSL)/TLS technology. Access to PHI within our systems is limited to workforce members who need it to perform their job functions, and we maintain administrative, physical, and technical safeguards designed to protect PHI from unauthorized access, use, or disclosure, consistent with the HIPAA Security Rule. Where we share PHI with third parties who perform services on our behalf, such as scheduling or communication platforms, we require a Business Associate Agreement obligating that party to protect PHI to the same HIPAA standard we apply ourselves.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services, Office for Civil Rights. Filing a complaint will not affect the care you receive from us and will not be held against you.

To file a complaint with us, contact:

Privacy Officer
Shiloh Health LLC
2501 Parkview Dr, Suite 207
Fort Worth, TX 76102
Email: info@myshilohhealth.com
Phone: (682) 412-0131

To file a complaint with HHS:

U.S. Department of Health and Human Services, Office for Civil Rights
Website: www.hhs.gov/ocr/complaints
Phone: 1-800-368-1019

Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have about you as well as any information we receive in the future. The current Notice will be available on this page and posted at our office.