Notice of Privacy Practices | Russak Dermatology Clinic & Russak+ Aesthetic Center

Effective date: August 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.

Russak Dermatology Clinic and Russak+ Aesthetic Center (together, “the Practice,” “we,” “us,” or “our”) provide medical dermatology, cosmetic and regenerative treatments, and related services at:

115 East 57th Street, Suite 1220
New York, NY 10022
Phone: 646-873-7546
Email: info@russakdermatology.com

This Notice of Privacy Practices (“Notice”) applies to protected health information (PHI) we create, receive, or maintain about you as a patient. It is required by the Health Insurance Portability and Accountability Act (HIPAA). It is not the same document as our website Privacy Policy, which explains cookies and online data.

Your Rights

When it comes to your health information, you have certain rights. This section explains those rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee as allowed by HIPAA and New York law (Public Health Law § 18).

Ask us to correct your medical record

You can ask us to correct health information about you that you think is incorrect or incomplete. We may say “no” to your request, but we will tell you why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.

If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information

You can ask for a list (accounting) of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this Notice at any time, even if you have agreed to receive the Notice electronically. We will provide you with a paper copy promptly. It is also posted at our office and on our website.

Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

You can complain if you feel we have violated your rights by contacting our Privacy Officer (see “Contact Us” below). You can also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by visiting hhs.gov/hipaa/filing-a-complaint, or by sending a letter to:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-800-368-1019

We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, tell us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care
• Share information in a disaster-relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

• Marketing purposes (for example, using your name or before-and-after photographs on our website or social media)
• Sale of your information
• Most sharing of psychotherapy notes, if we maintain them

“We do not contact patients for fundraising.”

Our Uses and Disclosures

We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you.

Example: A dermatologist, physician assistant, or aesthetic clinician involved in your care reviews your chart, photographs, and lab results to plan a procedure. We may also send a prescription to your pharmacy or share records with a referring physician.

Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information to schedule and remind you of appointments, train staff, review quality of care, and maintain our electronic records system.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about your visit to your health insurance plan so it will pay for eligible medical dermatology services. Cosmetic services you pay for privately are billed to you; we still use the information to process that payment.

How else can we use or share your health information?

We are allowed or required to share your information in other ways — usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see hhs.gov/hipaa.

Help with public health and safety issues. We can share health information about you for certain situations such as:

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications or devices
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

Do research. We can use or share your information for health research when permitted by law, including under an Institutional Review Board or privacy-board waiver, or with your authorization when required.

Comply with the law. We will share information about you if state or federal laws require it, including with the U.S. Department of Health and Human Services if it wants to see that we are complying with federal privacy law.

Respond to organ and tissue donation requests. We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director. We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests. We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions. We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Business associates. We hire vendors to help us operate (for example, our electronic health record, billing company, IT and cloud hosts, and some laboratories). If they need PHI to do that work, they sign a Business Associate Agreement requiring them to protect it.

Substance Use Disorder Records (42 CFR Part 2)

Federal law gives extra protection to certain substance use disorder (SUD) treatment records covered by 42 CFR Part 2. This Practice is not a federally assisted SUD treatment program. If we receive or maintain Part 2 records about you (for example, as part of a referral), we will use and disclose those records only as Part 2 and HIPAA allow, which in many cases means we need your written consent before sharing them for treatment, payment, or operations with other providers or plans.

If this Practice later becomes a Part 2 program, we will update this Notice. Confirm this paragraph with counsel; HHS now expects NPPs to address Part 2 even when the practice is not itself a Part 2 program.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this Notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Photographs, Testimonials, and Marketing

Clinical photographs used for your diagnosis and treatment are part of your medical record. We do not use your name, photo, or treatment details on our website, social media, or advertisements unless you sign a separate HIPAA authorization that describes what we may use, where it may appear, and when permission ends. You may revoke that authorization in writing, except to the extent we have already relied on it.

Changes to the Terms of This Notice

We can change the terms of this Notice, and the changes will apply to all information we have about you. The new Notice will be available upon request, in our office, and on our website. The effective date will appear at the top.

Contact Us

Questions about this Notice, your rights, or a complaint:

Andrew Sorokin, COO
Russak Dermatology Clinic / Russak+ Aesthetic Center
115 East 57th Street, Suite 1220
New York, NY 10022
Phone: 646-873-7546
Email: info@russakdermatology.com