Privacy Policy

DEXASCAN.COM

Authorization for Disclosure of Health Information via FHIR

Patient / Client Consent & Data-Sharing Restrictions

PLEASE READ BEFORE SIGNING

This form lets you decide whether DEXASCAN may share your health information electronically with apps, developers, or services you choose. Signing is voluntary. DEXASCAN will still provide your scan and services whether or not you sign.

1.  Who This Authorization Involves

Covered Entity / Data Holder:  DEXASCAN.com, operated by DEXA Plus LLC and its participating scan locations (“DEXASCAN,” “we,” or “us”).

You:  The patient or client whose health information is described below, identified by selecting yes

Recipient(s):  The third-party application, developer, or service you authorize to receive your data through a FHIR® (Fast Healthcare Interoperability Resources) connection — for example, a fitness, nutrition, GLP-1, or health-tracking app you connect to your DEXASCAN account.

2.  What Information May Be Shared

If you authorize sharing, the following categories of your health information may be transmitted through a FHIR-based interface to the recipient you select:

  • Body composition results — fat mass, lean/muscle mass, bone density, visceral fat, and related DEXA scan measurements;
  • Scan metadata — dates, locations, scan type, and device information;
  • Trend and history data — prior results used to calculate change over time;
  • Basic demographics — name, date of birth, sex, height, and weight, only as needed to match and interpret results;
  • Account identifiers — technical identifiers used to link your records across systems.

YOU CONTROL THE SCOPE

You may authorize all of the categories above, or restrict sharing to only the categories you select in Section 4. Anything you do not authorize will not be shared.

3.  Purpose of the Disclosure

Your information will be shared only for the purpose you choose when you connect an app or service — typically to let that app display, track, or analyze your body composition data alongside other health information at your direction. DEXASCAN does not sell your health information, and does not share it for advertising or marketing by third parties.

4.  Your Data-Sharing Restrictions

Mark the option that reflects your choice. You may change these choices at any time (see Section 6).

  • ☐  Authorize full sharing.  Share all categories in Section 2 with the recipient I connect.
  • ☐  Do not share.  Do not transmit my information through any FHIR connection at this time.

Sensitive-data note:  If any of your records include information with special protections under state or federal law, that information will be shared only if you specifically authorize it here: ____________________________.

5.  Important Notice About Re-Disclosure

PLEASE UNDERSTAND THIS BEFORE YOU AGREE

Once your information is sent to an app or clinic you choose, that recipient may NOT be a HIPAA-covered entity and is governed by its own privacy policy — not by HIPAA and not by DEXASCAN. Information disclosed under this authorization may be re-disclosed by the recipient and may no longer be protected by federal health-privacy law.

Before connecting any app, we encourage you to review that app’s privacy policy so you understand how it will use, store, and protect your information.

6.  Your Right to Change or Revoke

  • Revoke at any time.  You may revoke this authorization at any time by disconnecting the app in your DEXASCAN account or by submitting a written request to the contact in Section 9.
  • Effect of revoking.  Revocation stops future sharing but does not undo disclosures already made while the authorization was active.
  • Expiration (date or event).  This authorization expires on December 31, 2050. Unless revoked by you.

7.  Your HIPAA Rights & Required Statements

Federal law (the HIPAA Privacy Rule, 45 CFR §164.508) requires that we give you the following statements before you sign:

  • Right to revoke.  You may revoke this authorization in writing at any time (see Section 6). Your revocation will not apply to information already used or disclosed in reliance on this authorization.
  • Potential for re-disclosure.  Information disclosed under this authorization may be re-disclosed by the recipient and may no longer be protected by federal health-privacy law (see Section 5).

You also have the right to:

  • Inspect and obtain a copy of the health information described here, as permitted by law;
  • Request restrictions on how your information is used or disclosed;
  • File a complaint with DEXASCAN 

9.  Questions & Contact

DEXASCAN Office— DEXA Plus LLC

141 Peyerk Ct. Unit D

Romeo, Mi 48065

support@dexaplus.com

You have the right to receive a copy of this signed authorization.

Acknowledgment

By clicking below, I confirm that I have read and understand this authorization, that signing is voluntary. I understand I may revoke this authorization as described in Section 6.

Appendix A — Plain-Language Summary of HIPAA Rules

FOR YOUR REFERENCE

This summary is provided to help you understand the federal rules that protect your health information. It is a general overview, not a complete statement of the law.

What HIPAA Is

HIPAA — the Health Insurance Portability and Accountability Act — is a federal law that sets national standards for protecting your health information. The HIPAA Privacy Rule and Security Rule limit who may see or receive your information and require safeguards to keep it secure.

Who HIPAA Applies To

HIPAA applies to “covered entities” (such as healthcare providers, including DEXASCAN scan locations, and health plans) and their “business associates.” It generally does NOT apply to consumer apps or developers you choose to share your data with — which is why this authorization explains that protections may end once your information reaches them.

Your Core HIPAA Rights

  • Access: You may inspect and get a copy of your health information, usually within 30 days of your request.
  • Amendment: You may ask us to correct information you believe is wrong or incomplete.
  • Accounting of disclosures: You may request a list of certain disclosures we have made.
  • Restriction requests: You may ask us to limit how your information is used or shared.
  • Confidential communications: You may ask us to contact you in a specific way or location.
  • Notice: You have a right to receive our Notice of Privacy Practices.
  • Authorization & revocation: Uses and disclosures beyond treatment, payment, and healthcare operations generally require your written authorization, which you may revoke.
  • Complaints: You may complain to us or to the HHS Office for Civil Rights without fear of retaliation.

The “Minimum Necessary” Principle

When HIPAA applies, we share only the minimum information necessary for the intended purpose. Because you direct the sharing under this authorization, the categories you select in Section 4 define what is sent.

Right of Access via FHIR / Apps

Federal interoperability rules give you the right to direct your health information to an application of your choice through secure interfaces such as FHIR. When you exercise this right, the app you choose — not DEXASCAN — controls and protects the data it receives under its own terms.

How to Reach the Federal Regulator

U.S. Department of Health and Human Services, Office for Civil Rights (OCR) — you may file a complaint online at www.hhs.gov/ocr or by mail. We will not retaliate against you for filing a complaint.