Revive IV Hydration & Wellness
Operated by Revive IV Hydration LLC
4235 Electric Road, Suite 101, Roanoke, VA 24018
Phone: 540-268-3579 | Email: contact@revivehydrationroanoke.com
Effective Date: 9/10/2026
Our Commitment to Your Privacy
Revive IV Hydration & Wellness is required by law to maintain the privacy of your protected health information ("PHI"), to provide you with this Notice describing our legal duties and privacy practices, and to follow the terms currently in effect.
How We May Use and Disclose Your Health Information
Treatment. We may use and disclose your PHI to provide, coordinate, or manage your care — for example, sharing information among our nurses, nurse practitioners, physician assistants, and Medical Director involved in your treatment.
Payment. We may use and disclose your PHI to bill and collect payment for services, including verifying insurance, HSA/FSA eligibility, or processing payment.
Health Care Operations. We may use and disclose your PHI for internal operations such as quality assessment, staff training, compliance activities, and business management.
Appointment Reminders and Wellness Information. We may contact you by phone, text, or email to remind you of appointments or to tell you about services that may interest you.
Individuals Involved in Your Care. With your agreement, or when permitted based on professional judgment, we may share relevant PHI with a family member, friend, or other person you identify as involved in your care.
As Required by Law. We will disclose PHI when required to do so by federal, state, or local law.
Public Health and Safety. We may disclose PHI to public health authorities, for reporting of certain diseases, injuries, or reactions to medications, and to prevent a serious threat to health or safety.
Health Oversight, Legal, and Law Enforcement. We may disclose PHI to health oversight agencies, in response to a court order or valid legal process, or as otherwise permitted or required by law.
Uses and Disclosures Requiring Your Written Authorization
Other than as described above, we will not use or disclose your PHI — including for marketing purposes or the sale of your PHI — without your written authorization. You may revoke a prior authorization in writing at any time, except to the extent we have already relied on it.
Your Rights Regarding Your Health Information
You have the right to:
- Inspect and copy your PHI, with limited exceptions.
- Request amendment of your PHI if you believe it is incomplete or inaccurate.
- Request an accounting of disclosures of your PHI made for purposes other than treatment, payment, or health care operations.
- Request restrictions on certain uses or disclosures of your PHI, including disclosures to family members involved in your care. We are not required to agree to all requested restrictions.
- Request confidential communications — for example, asking us to contact you only at a certain phone number or address.
- Obtain a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
- File a complaint if you believe your privacy rights have been violated (see below).
Our Duties
We are required by law to maintain the privacy of your PHI, provide you with this Notice of our legal duties and privacy practices, and abide by the terms of the Notice currently in effect. We reserve the right to change the terms of this Notice and to make the revised Notice effective for all PHI we maintain. Revised notices will be made available at our clinic and on our website.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be retaliated against for filing a complaint.
Revive Privacy Officer
Jordan Sorensen – Chief Financial Officer
4235 Electric Road, Suite 101, Roanoke, VA 24018
Phone: 540-268-3579
Email: contact@revivehydrationroanoke.com
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints
Contact Information
For questions about this Notice or our privacy practices, please contact us at:
Revive IV Hydration & Wellness
4235 Electric Road, Suite 101, Roanoke, VA 24018
Phone: 540-268-3579
Email: contact@revivehydrationroanoke.com
