We are pleased to announce that we now accept all major credit cards, as well as HSA and FSA for payment!

Notice of Privacy Practices (HIPPA)

Last Updated: January 1, 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.

Our Commitment to Your Privacy

Optimal Female Wellness is committed to protecting the privacy and confidentiality of your protected health information (PHI). We are required by law to maintain the privacy of your health information and provide you with this Notice of Privacy Practices.

Your health information may be used and disclosed for treatment, payment, and healthcare operations as permitted by law.

How We May Use and Disclose Your Health Information

We may use or share your health information in the following ways:

Treatment

We may use your health information to provide medical care and services. This includes communication between healthcare providers involved in your care.

Example: Sharing your medical information with another provider or specialist when necessary for treatment.

Payment

We may use your information to bill and receive payment for services.

Example: Sending necessary information to insurance providers or payment processors.

Healthcare Operations

We may use your information to support the operation of our practice.

Examples include:

Appointment Reminders

We may contact you to remind you of scheduled appointments.

Communication may include:

  • Phone calls
  • Emails
  • Text Messages

As Required by Law

We may disclose health information when required by federal, state, or local laws.

Public Health & Safety

We may disclose information for public health purposes, including:

  • Preventing disease
  • Reporting health concerns
  • Responding to emergencies

Your Rights Regarding Your Health Information

You have the right to:

Access Your Records

You may request copies of your medical records.

Request Corrections

You may request corrections if you believe your information is incorrect.

Request Restrictions

You may request limits on how your information is used or shared.

Request Confidential Communications

You may request that we contact you using specific methods.

Receive an Accounting of Disclosures

You may request a list of certain disclosures of your information.

Public Health & Safety

You may file a complaint if you believe your privacy rights have been violated.

Complaints may be submitted to:

Optimal Female Wellness
(623) 335-9004

Our Responsibilities

We are required to:

  • Maintain the privacy of your information
  • Provide this notice
  • Follow the terms currently in effect
  • Notify you if a breach of your information occurs

Changes to This Notice

We reserve the right to update this notice at any time. Updated versions will be available upon request and posted on our website.

Telehealth Consent Form

Optimal Female Wellness – Telehealth Informed Consent

Telehealth services involve the use of electronic communications to provide healthcare services remotely.

By participating in telehealth services, you acknowledge and agree to the following:

Nature of Telehealth Services

Telehealth may include:

  • Video consultations
  • Phone consultations
  • Secure messaging
  • Remote monitoring

Telehealth services allow providers to diagnose, consult, treat, and educate patients remotely.

Potential Benefits

Telehealth may:

  • Improve access to care
  • Reduce travel time
  • Increase convenience
  • Provide timely medical services

Potential Risks

Risks associated with telehealth may include:

  • Technical difficulties
  • Interruptions in communication
  • Security risks despite safeguards
  • Limited ability to perform physical examinations

Confidentiality

Reasonable steps will be taken to protect your privacy. However, electronic communication may carry inherent risks.

Patient Responsibilities

You agree to:

  • Provide accurate information
  • Use secure internet access when possible
  • Participate in a private setting
  • Follow provider instructions

Consent to Telehealth

By participating in telehealth services, you:

  • Acknowledge understanding the risks and benefits
  • Consent to receive telehealth services
  • Understand you may withdraw consent at any time

Financial Policy

Optimal Female Wellness – Financial Policy

Thank you for choosing Optimal Female Wellness for your care.

Payment Responsibility

Payment is due at the time of service unless prior arrangements are made.

Accepted forms of payment may include:

  • Credit cards
  • Debit cards
  • Cash
  • HSA/FSA accounts
  • Approved financing options

Patients are responsible for all charges incurred.

Insurance (If Applicable)

If insurance is accepted:

  • Insurance coverage is not guaranteed
  • Patients remain responsible for uncovered services
  • Co-pays and deductibles are due at the time of service

Late Payments

Accounts with unpaid balances may be subject to:

  • Late fees
  • Collection activity
  • Suspension of services

Missed Appointments

Missed appointments or late cancellations may result in fees.

Recommended policy:

  • 24-hour cancellation notice required
  • Late cancellations or no-shows may incur a fee

Repeated missed appointments may result in discharge from the practice.

Refund Policy

Refunds are handled on a case-by-case basis depending on services rendered.

Certain medical or wellness services may be non-refundable once performed.

SMS / Text Message Consent Form

Optimal Female Wellness – SMS & Electronic Communication Consent

By providing your phone number, you consent to receive communications from Optimal Female Wellness.

Types of Messages You May Receive

You may receive:

  • Appointment reminders
  • Appointment confirmations
  • Follow-up instructions
  • Billing notifcations
  • Administrative messages

Message Frequency

Message frequency may vary depending on your care needs and appointment schedule.

Message & Data Rates

Standard message and data rates may apply depending on your mobile carrier.

Opt-Out Instructions

You may opt out of SMS communications at any time by:

  • Replying STOP to any text message
  • Contacting our office directly

Opting out may limit our ability to send appointment reminders.