This notice describes our privacy practices concerning sharing of your personal health information. We protect your confidentiality in accordance with federal and Colorado state law. Your treatment records with Kismet Ketamine Clinic are confidential. However, Kismet Ketamine Clinic may share your information without your prior authorization in the following situations:

• Your treatment. Kismet Ketamine Clinic may share your health information to provide, manage, and coordinate your care, including sharing your information with medical providers within Kismet Ketamine Clinic as well as providers outside of Kismet Ketamine Clinic.

• Payment. Kismet Ketamine Clinic may share personal information to collect payment for products and services.

• Health care operations. Kismet Ketamine Clinic may share your information for the purposes of health care operations, including but not limited to quality assessment and improvement, development of clinical guidelines, management and care coordination, review of provider competence, medical review, auditing, fraud detection, and business management.

In addition to these purposes, you may also authorize release of your information to third-parties by completing and signing the authorization form, available per patient request.

By signing this privacy policy, you agree that Kismet Ketamine Clinic may use or disclose your personal health information for the purposes of carrying out treatment, obtaining payment, and health care operations.