Effective Date: August 11, 2026

At Williamson Pain Institute, protecting your privacy is an important part of the care we provide. This Notice explains how your Protected Health Information (PHI) may be used and disclosed, your rights regarding your health information, and our responsibilities under the Health Insurance Portability and Accountability Act (HIPAA).

Please read this Notice carefully. If you have any questions, a member of our team will be happy to assist you.

Your Rights

You have important rights regarding your medical information. Subject to certain legal limitations, you may:

• Request a copy of your medical records in paper or electronic format.
• Request corrections to information you believe is inaccurate or incomplete.
• Ask us to communicate with you through alternative methods or at alternate locations.
• Request restrictions on certain uses or disclosures of your health information.
• Receive an accounting of certain disclosures of your health information.
• Receive a paper copy of this Notice at any time.
• Authorize another individual to act on your behalf when legally permitted.
• File a complaint if you believe your privacy rights have been violated.

How We May Use and Disclose Your Information

Federal law allows us to use and disclose your Protected Health Information without your written authorization for the purposes described below.

Treatment

We may use and share your health information with physicians, specialists, hospitals, imaging centers, laboratories, pharmacies, physical therapists, or other healthcare professionals involved in your treatment to ensure you receive appropriate care.

Payment

We may use your information to bill and receive payment from your health insurance provider, Medicare, Medicaid, or other responsible parties for services provided.

Healthcare Operations

We may use your information to support the operation and quality of our practice, including:

• Quality improvement activities
• Staff education and training
• Performance evaluations
• Licensing and accreditation
• Business management and administration

Other Permitted Uses and Disclosures

Federal and state laws permit or require us to disclose your information in certain circumstances, including:

• Public health reporting
• Reporting abuse or neglect
• Workers’ compensation claims
• Law enforcement requests as permitted by law
• Court orders and legal proceedings
• Health oversight activities
• Coroners, medical examiners, and funeral directors
• Organ and tissue donation organizations
• Disaster relief efforts
• Certain national security activities authorized by law

Uses That Require Your Authorization

Other than the situations described in this Notice, we will obtain your written authorization before using or disclosing your health information. You may revoke your authorization at any time in writing, except where we have already relied upon it.

Our Responsibilities

We are required by law to:

• Maintain the privacy and security of your Protected Health Information.
• Provide you with this Notice of our legal duties and privacy practices.
• Follow the terms of the Notice currently in effect.
• Notify you if a breach occurs that may compromise the privacy or security of your information.

Changes to This Notice

We reserve the right to change this Notice at any time. Any revised Notice will apply to all Protected Health Information we maintain. The current version will always be available in our office and on our website.

Questions or Complaints

If you have questions about this Notice or believe your privacy rights have been violated, please contact our office. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will never retaliate against you for filing a complaint.

Contact Information

Williamson Pain Institute
1603 Medical Parkway, Building 3, Suite 330
Cedar Park, TX 78613
Phone: (512) 244-3838

Last Updated: August 11, 2026