Notice of Privacy Practices

Effective September 28, 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.

BioForm Rx is a DBA (assumed name) of The Tide Clinic PLLC, a Texas professional limited liability company. Our mailing address is 6909 Grand Blvd, Houston, TX 77054. Questions about this document can be sent to support@bioformrx.com.

Our commitment

The Tide Clinic PLLC, doing business as BioForm Rx, is required by law to maintain the privacy of your protected health information (PHI), to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect. We will notify you if a breach occurs that may have compromised the privacy or security of your information.

How we may use and disclose your health information

For treatment

We use your health information to provide medical care and share it with other professionals involved in your care, including the pharmacy that fills your prescription, the laboratory that performs your tests, and other clinicians we consult or refer you to.

For payment

We use and disclose your health information to bill and collect payment for services, for example to process your payment and to verify charges with your payment processor.

For healthcare operations

We may use your health information to run our practice, improve your care, train staff, conduct quality reviews, and comply with certification and regulatory requirements.

Other uses permitted or required by law

When required by federal, state or local law.
For public health activities, such as reporting adverse drug reactions to the FDA or communicable diseases to health authorities.
To health oversight agencies, including state medical and pharmacy boards, for audits, investigations and licensure.
In response to a court order, subpoena or other lawful process.
To prevent a serious threat to your health or safety or that of others.
For workers’ compensation, law enforcement, or coroner and medical examiner purposes as permitted by law.
To business associates who perform services for us under contracts that require them to protect your information.

Uses that require your written authorization

We will not use or disclose your health information for marketing, sell your health information, or share psychotherapy notes without your written authorization. Other uses and disclosures not described in this notice will be made only with your written authorization, which you may revoke in writing at any time, except to the extent we have already acted on it.

Communications with you

We may contact you by email, text message, phone or the patient portal about appointments, lab results, prescriptions, refills and treatment options. Email and text messages may not be fully secure; you may ask us to contact you in a different way or at a different location, and we will accommodate reasonable requests.

Your rights

Get a copy of your medical record. Ask for an electronic or paper copy of your record. We will provide it within 30 days and may charge a reasonable, cost-based fee.
Ask us to correct your record. If you believe information is incorrect or incomplete, you may ask us to amend it. We may deny the request in writing with an explanation.
Request confidential communications. Ask us to contact you in a specific way or at a specific address.
Ask us to limit what we use or share. We are not required to agree, except that if you pay for a service in full out of pocket, you may ask us not to share that information with your health insurer for payment or operations purposes, and we will honor that request.
Get a list of those with whom we have shared your information. You may request an accounting of disclosures for the six years before your request, excluding disclosures for treatment, payment, operations and certain others.
Get a copy of this notice. You may ask for a paper copy at any time.
Choose someone to act for you. A person with medical power of attorney or a legal guardian may exercise your rights on your behalf.
File a complaint. If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below, or with the U.S. Department of Health and Human Services Office for Civil Rights at www.hhs.gov/ocr/privacy/hipaa/complaints. We will not retaliate against you for filing a complaint.

Texas and state law

Texas law and the laws of other states in which we practice may provide greater privacy protections than HIPAA. Where state law is more protective, we follow state law. Texas law generally prohibits us from disclosing your health information electronically without your authorization except as permitted by law, and requires us to provide electronic copies of records within 15 business days of a written request.

Changes to this notice

We may change this notice and the changes will apply to all information we have about you. The current notice is always available at bioformrx.com/notice-of-privacy-practices and on request.

Contact our Privacy Officer

Privacy Officer
The Tide Clinic PLLC d/b/a BioForm Rx
6909 Grand Blvd, Houston, TX 77054
privacy@bioformrx.com