Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. Blue Sky IV (“Blue Sky IV,” “we,” “our,” or “us”) is committed to protecting the privacy and security of your health information. This Notice of Privacy Practices (“Notice”) explains how we may use and disclose your protected health information (“PHI”), your rights regarding your PHI, and our responsibilities under applicable federal and state privacy laws, including the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). This Notice applies to health information created, received, maintained, or transmitted by Blue Sky IV in connection with the services we provide to you.

Blue Sky IV is required by law to: • Maintain the privacy of your protected health information. • Provide you with this Notice describing our legal duties and privacy practices. • Follow the terms of the Notice currently in effect. • Notify you if a breach occurs that compromises the privacy or security of your unsecured protected health information, when notification is required by law. • Provide you with access to your health information as required by law. • Limit uses and disclosures of your health information to the minimum necessary when applicable. We reserve the right to change this Notice. Any revised Notice will apply to health information we already maintain as well as information we receive in the future. A current copy of our Notice will be made available upon request and may be posted on our website.

We may use or disclose your protected health information without obtaining your separate written authorization for certain purposes permitted by law. Treatment We may use and disclose your health information to provide, coordinate, or manage your healthcare. For example, we may share relevant health information with healthcare professionals involved in your care when necessary to provide treatment or coordinate services. Payment We may use or disclose your health information to obtain payment for services we provide. For example, we may use information about your services to process payments or respond to billing-related questions. Healthcare Operations We may use or disclose your health information for healthcare operations, including activities necessary to operate and improve our practice. Examples may include: • Quality assessment and improvement. • Staff training and competency activities. • Clinical record review. • Compliance and auditing activities. • Business administration. • Credentialing and provider activities. • Patient safety activities. • Evaluating the effectiveness of our services. Appointment Reminders and Communications We may use your health information to contact you regarding appointments, scheduling, treatment-related information, or other healthcare-related communications. We may contact you by telephone, text message, email, patient portal, or other communication method you have provided. You may request that we communicate with you through a particular method or at a particular location. We will consider reasonable requests as required by law.

We may use or disclose your health information without your authorization when permitted or required by applicable law, including for the following purposes: As Required by Law We may disclose health information when federal, state, or local law requires us to do so. Public Health Activities We may disclose health information for public health activities permitted or required by law, such as reporting certain diseases, injuries, or other public health matters. Abuse, Neglect, or Domestic Violence We may disclose health information to appropriate government authorities when required or permitted by law to report suspected abuse, neglect, or domestic violence. Health Oversight Activities We may disclose health information to governmental agencies for activities authorized by law, such as audits, investigations, inspections, licensing activities, and disciplinary proceedings. Legal Proceedings We may disclose health information in response to a court order, administrative order, subpoena, discovery request, or other lawful process when the applicable legal requirements have been satisfied. Law Enforcement We may disclose certain health information to law enforcement when permitted or required by applicable law. Serious Threats to Health or Safety We may disclose health information when necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public, when permitted by law. Workers' Compensation We may disclose health information as authorized by and to the extent necessary to comply with workers' compensation laws and other similar programs. Organ and Tissue Donation We may disclose health information for purposes related to organ, eye, or tissue donation and transplantation when permitted by law. Coroners, Medical Examiners, and Funeral Directors We may disclose health information to coroners, medical examiners, and funeral directors as permitted by law. Research We may use or disclose health information for research purposes when permitted by applicable law and appropriate privacy protections are in place. Specialized Government Functions We may disclose health information for certain specialized government functions, including authorized military, national security, intelligence, and protective services activities, when permitted by law.

Certain uses and disclosures of your protected health information require your written authorization. Examples may include: • Certain uses or disclosures of psychotherapy notes, when applicable. • Uses or disclosures for marketing purposes when authorization is required. • Certain disclosures involving the sale of protected health information. • Other uses or disclosures that are not otherwise permitted or required by law. If we obtain your written authorization, you may revoke that authorization in writing at any time, except to the extent we have already relied upon it.

You have the following rights regarding your protected health information, subject to certain limitations and exceptions established by law. Right to Inspect and Obtain a Copy You have the right to inspect and obtain a copy of your protected health information maintained by us, as permitted by law. You may be required to submit your request in writing. We may charge a reasonable, cost-based fee where permitted by law. Right to Request an Amendment If you believe information in your medical record is incorrect or incomplete, you may request that we amend the information. Your request must generally be made in writing and explain why you believe an amendment is appropriate. We may deny your request in certain circumstances permitted by law. Right to Request Restrictions You may request restrictions on how we use or disclose your health information for treatment, payment, or healthcare operations. We are not required to agree to every restriction request. However, if you request that we not disclose your health information to a health plan for payment or healthcare operations purposes and you have paid for the healthcare service completely out of pocket, we will comply with the request when required by HIPAA, unless disclosure is otherwise required by law. Right to Request Confidential Communications You may request that we communicate with you about your health information in a specific manner or at a specific location. For example, you may request that we contact you only by telephone, email, or at a particular address. We will accommodate reasonable requests as required by law. Right to Receive a Paper Copy of This Notice You may request a paper copy of this Notice at any time, even if you have agreed to receive it electronically. Right to an Accounting of Certain Disclosures You have the right to request an accounting of certain disclosures of your protected health information made by us, subject to limitations and exceptions under applicable law. Right to Receive Notice of a Breach You have the right to receive notification if your unsecured protected health information is breached in a manner that requires notification under HIPAA.

Certain types of health information may receive additional protection under federal or state law. For example, certain information relating to: • Mental health and psychotherapy. • Substance use disorder treatment. • HIV/AIDS. • Genetic information. • Reproductive health. • Other specially protected categories. Where applicable, Blue Sky IV will comply with additional privacy requirements governing such information.

Blue Sky IV will comply with applicable federal and state requirements concerning the privacy of reproductive health information. Where applicable, certain uses or disclosures of protected health information related to reproductive healthcare may require a specific attestation or may otherwise be restricted by law. We will not use or disclose protected health information in a manner prohibited by applicable law.

Because Blue Sky IV provides mobile healthcare services, we may communicate with you electronically or by telephone regarding appointments, services, treatment-related matters, and other healthcare operations. Electronic communications may include: • Telephone calls. • Text messages. • Email. • Patient portals. • Electronic medical records. • Electronic payment systems. While we take reasonable safeguards to protect your information, electronic communications may carry privacy and security risks. Please notify us if you prefer a different method of communication.

Blue Sky IV may use third-party companies or individuals to perform certain services on our behalf. These parties may be considered “business associates” under HIPAA when they create, receive, maintain, or transmit protected health information on our behalf. When required by law, Blue Sky IV will have appropriate agreements or other safeguards in place to protect your health information. Examples may include certain: • Electronic medical record providers. • Billing and payment companies. • Technology providers. • Scheduling platforms. • Legal or accounting professionals. • Administrative service providers.

You may have the right to request that we limit certain communications or contact you through a preferred method. If you do not wish to receive certain non-treatment-related communications, you may contact us using the information below. Please understand that opting out of certain communications may affect our ability to provide appointment reminders or other administrative communications.

Blue Sky IV maintains reasonable administrative, physical, and technical safeguards designed to protect your health information from unauthorized access, use, disclosure, alteration, or destruction. Examples may include: • Secure electronic medical record systems. • Password and access controls. • Workforce privacy and security training. • Secure handling of paper records. • Appropriate disposal of confidential information. • Policies governing mobile healthcare documentation. • Limiting workforce access to information based on job responsibilities. No method of electronic transmission or storage can be guaranteed to be completely secure. We nevertheless take reasonable steps to protect your information as required by law.

If you have questions about this Notice, believe your privacy rights have been violated, or wish to submit a privacy complaint, please contact: Blue Sky IV Privacy Officer: Michele Storz, Administrative Officer Address: 756 Brighton Circle City, State, ZIP: Port Barrington, IL 60010 Phone: (877) 7BLUSKY Email: connect@blueskyivwellness.com You will not be retaliated against for filing a privacy complaint.

If you believe your privacy rights have been violated, you may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. You may submit a complaint without fear of retaliation. U.S. Department of Health and Human Services Office for Civil Rights Complaints may be submitted through the HHS Office for Civil Rights website or by mail. For current complaint instructions and contact information, visit the official HHS Office for Civil Rights website.

You may be asked to acknowledge that you received this Notice of Privacy Practices. Your acknowledgment does not constitute authorization for uses or disclosures of your protected health information beyond those permitted by law. If you decline to sign an acknowledgment, we may still provide treatment or services when otherwise permitted.

This Notice of Privacy Practices is effective as of: Effective Date: 10-03-26 Blue Sky IV reserves the right to change the terms of this Notice and make the revised Notice applicable to all protected health information that we maintain. A current version of this Notice will be made available upon request.

Privacy Officer: Michele Storz, Administrative Officer Telephone: (877) 7BLUSKY Email: connect@blueskyivwellness.com Address: 756 Brighton Circle, Port Barrington, IL 60010 Website: www.blueskyivwellness.com