Effective Date: June 1, 2026
Wellington Orthopedic Institute | Dr. Michael Mikolajczak, DO
10115 Forest Hill Blvd, Suite 102, Wellington, FL 33414 | 561-670-2010 | info@wellingtonorthopedic.com
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.
Wellington Orthopedic Institute ("we," "us," or "our") is a medical practice operated by Dr. Michael R. Mikolajczak, DO, located at 10115 Forest Hill Blvd, Suite 102, Wellington, FL 33414. We are committed to protecting the privacy of your health information and complying with all applicable laws, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations.
We understand that medical information about you and your health is personal. We are committed to protecting it. This Notice explains:
The following describes the ways we may use and disclose your health information. Not every use or disclosure will be listed, but all of the ways we are permitted to use and disclose information will fall into one of these categories.
We may use your health information to provide you with medical treatment or services. We may disclose your health information to doctors, nurses, technicians, medical students, or other personnel who are involved in taking care of you. For example, a doctor treating you for a knee injury may need to know if you have diabetes, because diabetes may slow the healing process.
We may use and disclose your health information so that the treatment and services you receive may be billed to and payment collected from you, an insurance company, or a third party. For example, we may need to give your health plan information about a procedure you received so your health plan will pay us or reimburse you for the procedure.
We may use and disclose your health information for healthcare operations. These uses and disclosures are necessary to run our practice and make sure that our patients receive quality care. For example, we may use health information to review our treatment and services and to evaluate the performance of our staff.
We may use and disclose your health information to contact you about appointment reminders or information about other treatment alternatives or other health-related benefits and services that may be of interest to you.
We will disclose your health information when required to do so by federal, state, or local law.
We may disclose your health information for public health activities such as preventing or controlling disease, injury, or disability; reporting births and deaths; reporting child abuse or neglect; reporting reactions to medications or problems with products; notifying people of recalls of products they may be using; or notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
We may disclose your health information to a health oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the healthcare system, government programs, and compliance with civil rights laws.
If you are involved in a lawsuit or a dispute, we may disclose your health information in response to a court or administrative order. We may also disclose health information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute.
We may release your health information if asked to do so by a law enforcement official in response to a court order, subpoena, warrant, summons, or similar process; to identify or locate a suspect, fugitive, material witness, or missing person; about the victim of a crime; about a death we believe may be the result of criminal conduct; about criminal conduct at our practice; or in emergency circumstances to report a crime.
We may release your health information for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness. Dr. Mikolajczak is a certified medical examiner for workers' compensation cases.
You have the following rights regarding health information we maintain about you:
You have the right to inspect and copy health information that may be used to make decisions about your care. To inspect and copy your health information, you must submit your request in writing to our Privacy Officer. We may charge a fee for the costs of copying, mailing, or other supplies associated with your request.
If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing and submitted to our Privacy Officer. We may deny your request if it is not in writing, does not include a reason to support the request, or if we determine that the information or record that is the subject of the request was not created by us, is not part of the health information kept by or for our practice, is not part of the information you would be permitted to inspect and copy, or is accurate and complete.
You have the right to request an accounting of disclosures. This is a list of the disclosures we made of medical information about you for purposes other than treatment, payment, and healthcare operations, and certain other activities. Your request must state a time period, which may not be longer than six years from the date of disclosure.
You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or healthcare operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment of your care. We are not required to agree to your request; however, if we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing to our Privacy Officer. We will not ask you the reason for your request. We will accommodate all reasonable requests.
You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy. You may contact our Privacy Officer to obtain a paper copy.
When you visit wellington-orthopedic-institute.vercel.app or wellingtonorthopedic.com, we may collect certain non-personal information automatically, including browser type, IP address, pages viewed, and time spent on the site. This information is used in aggregate to improve the website experience and is not linked to any personal health information.
If you submit a contact form or appointment request on our website, we collect your name, phone number, email address, and the general nature of your inquiry. Please do not submit protected health information (detailed medical history, diagnoses, test results, or insurance information) through website forms. Such information should be provided directly to our office by phone or in person.
Our website may use cookies and similar tracking technologies to improve your experience. You may disable cookies through your browser settings. Disabling cookies will not affect your ability to access the informational content of our website.
Our website may utilize third-party services including analytics platforms and scheduling tools. These services have their own privacy policies and may collect information independently. We encourage you to review the privacy policies of any third-party services you interact with through our website.
Our website does not respond to "Do Not Track" signals from browsers at this time.
We maintain physical, electronic, and procedural safeguards that comply with federal regulations to protect your health information. Our staff are trained on privacy and security policies and are required to maintain the confidentiality of patient information.
No method of transmission over the Internet or method of electronic storage is 100% secure. While we strive to use commercially acceptable means to protect your personal information, we cannot guarantee its absolute security.
We reserve the right to change this notice and to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our office and on our website. The notice will contain the effective date on the first page.
If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, contact our Privacy Officer in writing at the address below. All complaints must be submitted in writing.
You will not be penalized for filing a complaint.
To file a complaint with the U.S. Department of Health and Human Services, visit hhs.gov/hipaa/filing-a-complaint or call 1-800-368-1019.
Florida residents have additional rights under Florida Statutes Chapter 456 and Chapter 395. We comply with all applicable Florida state laws regarding the privacy and confidentiality of patient records. In cases where Florida state law provides greater privacy protections than HIPAA, we will comply with Florida law.
For questions about this notice or to exercise your rights, contact:
Wellington Orthopedic Institute — Privacy Officer
10115 Forest Hill Blvd, Suite 102
Wellington, FL 33414
Phone: 561-670-2010
Email: info@wellingtonorthopedic.com
This Privacy Policy was prepared for Wellington Orthopedic Institute and should be reviewed by legal counsel before final adoption. It is intended as a starting framework for HIPAA compliance. The practice should ensure this policy is reviewed and approved by a qualified healthcare attorney.