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Agreement
I affirm that I will consult a physician regarding the condition I have according to requirement of Manhattan
Acupuncture and Natural Herbs, P.C. policies. And I also authorize this clinic to use my personal information
to contact me via email, phone, fax, letter. If I have any questions, I will contact them instantly.
Notice of Policy
- This is defined as a remote service via mail. The clinic chooses to maintain the privacy of health
information about you (“Protected Health Information” or “PHI”) and to provide you with this Notice of
our duties and privacy practices with respect to PHI. When we use or disclose PHI, we are required to
abide by the terms of this Notice (or other notice in effect at the time of the used or disclosure).
- You are required to follow our instructions while taking this our treatments.
- We may use and disclose PHI in order to treat you and conduct our “clinic care operations” such as
treatment, information leaflets, etc.
- We may disclose PHI for the following public health activities: to report health information to public
health authorities for the purpose of preventing or controlling disease, injury, or disability; to report
information about products and services under the jurisdiction of the U.S. Food and Drug
Administration.
- We may disclose PHI in the course of a judicial or administrative proceeding in response to a legal order
or other lawful process.
- If you desire further information about your privacy rights, are concerned that we have violated your
privacy rights, or disagree with a decision that we made about access to PHI, you may contact Privacy
Compliance Officers. You may also file written complaints with the Director, Office for Civil Rights of
the U.S. Department of Health and Human Services. Upon request, the Privacy Compliance Officers will
provide you with the correct address for the Director. We will not retaliate against you if you file a
complaint with either us or the Director.
- You may request restrictions on our use and disclosure of PHI (1) for treatment, payment, and other
treatment operations; (2) to individuals (such as a family member, other relative, close personal friend,
or any other person identified by you) involved with your care or with payment related to your care; or
(3) to notify or assist in the notification of such individuals regarding your location and general condition
- If you are not satisfied with our product, 100% money back guarantee. Please mail it back to us in 7
days of receipt with a letter of explanation. Any empty bottles won't be accepted. There should be at
least 3/4 of original amount of remedy. You have to be responsible for the mailing fee.
We are happy to give you a hand when you need help.
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$115.20
(10% saved
$12.80 saved)
4 bottles
for 1 month
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$230.40
(10%, saved
$25.60 saved)
8 bottles
for 2 months
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$337.92
(12% saved
$46.08 saved)
12 bottles
for 3 months
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