NOTICE OF PRIVACY PRACTICES
Modern Plastic Surgery · Effective Date: October 27, 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.
Who follows this Notice
This Notice applies to Modern Plastic Surgery, Shawn Moshrefi, MD, and all physicians, staff, and workforce members at our Calabasas and Beverly Hills offices.
Our duties
We are required by law to:
Maintain the privacy and security of your protected health information ("health information")
Give you this Notice of our legal duties and privacy practices
Notify you if a breach occurs that may have compromised the privacy or security of your unsecured health information
Follow the terms of the Notice currently in effect
We reserve the right to change this Notice. Changes will apply to all health information we hold. The current Notice will be posted in our offices and on our website, and you may request a copy at any time.
How we may use and disclose your health information
Treatment. We use and share your health information to provide care. Example: we may share information with your anesthesiologist, the surgical facility, or a physician who referred you.
Payment. We use and share information to bill and receive payment. Example: we may give information to your health plan to obtain approval for a reconstructive procedure, or to a patient financing company you choose to use.
Health care operations. We use and share information to run our practice and improve care. Example: we may review records to evaluate staff performance or to meet licensing and accreditation requirements.
Business associates. We may share information with vendors that perform services for us, such as billing, IT, or electronic records, under written agreements that require them to protect it.
Appointment reminders and care communications. We may contact you by phone, mail, email, or text with appointment reminders, care instructions, and information about treatment alternatives.
Family and friends involved in your care. We may share information with a family member, friend, or caregiver involved in your care or payment, unless you object. If you are unable to agree or object, we may share information if we believe it is in your best interest.
Other uses and disclosures allowed or required by law
We may use or share your health information without your authorization:
When required by federal, state, or local law
For public health activities, such as reporting disease, injury, or adverse events from medical products
To report suspected abuse, neglect, or domestic violence to government authorities
For health oversight activities, such as audits, investigations, and licensure
In judicial and administrative proceedings, in response to a court order or valid subpoena
For certain law enforcement purposes
To coroners, medical examiners, and funeral directors
For organ, eye, or tissue donation
For research approved under privacy protections required by law
To prevent a serious threat to health or safety
For specialized government functions, such as military, veterans, and national security purposes
For workers' compensation claims
For disaster relief efforts, unless you object
California law may give your information greater protection than federal law, for example for HIV test results and mental health information. Where it does, we follow the stricter law.
Uses that require your written authorization
We will not use or share your health information for the following without your written permission:
Marketing, except face-to-face communications or small promotional gifts
Sale of your health information
Psychotherapy notes, in most cases
Photographs, including before-and-after photos, for our website, social media, or advertising
Any other purpose not described in this Notice
You may revoke an authorization in writing at any time, except to the extent we have already acted on it.
Your rights
Get a copy of your records. You may inspect or get an electronic or paper copy of your medical and billing records. We may charge a reasonable, cost-based fee.
Ask us to correct your records. You may ask us to amend information you believe is incorrect or incomplete. We may deny your request, and will tell you why in writing within 60 days.
Request confidential communications. You may ask us to contact you in a specific way, such as a different phone number or address. We will agree to all reasonable requests.
Ask us to limit what we use or share. You may ask us not to use or share certain information. We are not required to agree, except that if you pay for a service in full out of pocket, we must agree not to share that information with your health plan for payment or operations, unless the law requires it.
Get a list of disclosures. You may ask for a list of the times we shared your information in the six years before your request, other than for treatment, payment, operations, and certain other disclosures. One list per year is free.
Get a paper copy of this Notice at any time, even if you agreed to receive it electronically.
Choose someone to act for you. A person with medical power of attorney or your legal guardian may exercise your rights.
To exercise any of these rights, contact our Privacy Officer in writing at the address below.
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 at 200 Independence Avenue S.W., Washington, D.C. 20201, by calling 1-877-696-6775, or online at www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.
Contact our Privacy Officer
Privacy Officer, Modern Plastic Surgery
23945 Calabasas Rd #116, Calabasas, CA 91302
(818) 823-0655 · info@modernplasticsurgeryla.com