HIPAA PRIVACY POLICY & SMS COMMUNICATION POLICY

Effective Date: 01-01-2026

NJ Weight Loss & Preventive Care Clinics, PA (“NJ WEIGHT LOSS”) is committed to protecting your medical and personal information in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

NJ Weight Loss and Preventive Care Clinics PA

Campaign Compliance Documentation

420 Route 46 E., Suite #6, Fairfield, NJ 07004

Phone: 856-630-7556 | Email: Jbock@njweightloss.us

https://njweightloss.us | Compliance Officer: James Bock, CEO

SMS CAMPAIGN PARAMETERS AND RULES:

Section 1: Campaign Description

NJ Weight Loss and Preventive Care Clinics PA is an in person medical provider with two NJ OFFICES with telehealth support, whose medical director is licensed to practice in all 50 states, specializing in GLP-1 medications (semaglutide, tirzepatide), testosterone replacement therapy (TRT), hormone optimization, and peptide therapies. Our SMS messaging program supports active and prospective patients with appointment reminders, care coordination, prescription updates, lab/bloodwork notifications, health coaching guidance, and personalized promotional text messages offering discounts on medications and services specifically related to each patient’s active treatment plan.

SMS messages are sent only to individuals who have provided explicit written opt-in consent as part of our patient registration and intake process. Messaging includes both transactional care communications and, where consented, targeted promotional texts with discounts on medications and services relevant to the patient’s current care. Messages will not exceed 8 per month per patient.

Message types used in this campaign include:

- Appointment scheduling confirmations and reminders

- Prescription status and refill notifications

- Lab and bloodwork result alerts and follow-up instructions

- Care coordination and provider follow-up messages

- Billing, invoice, and payment notifications

- Patient re-engagement for lapsed care continuity

- Health and wellness educational content for enrolled patients

- Program onboarding instructions for new patients

- Personalized promotional text offers — discounts on medications and services specifically tied to the patient’s active treatment program (e.g., GLP-1, TRT, peptide therapies)

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Section 2: Opt-In Process (Who, What, When, Where, How & Cost)

WHO

Opt-in consent is collected from: (1) new patients completing online registration at https://njweightloss.us, (2) patients completing in-office intake paperwork at our clinic located at 428 Route 46 E., Suite #6, Fairfield, NJ 07004, or (3) existing patients who request SMS communications via their patient portal or by contacting our patient care team at 856-630-7556.

WHAT

Patients provide explicit, separate written authorization specifically for SMS communications. This is a standalone consent checkbox or signature field — it is not bundled with or buried within general terms of service or medical consent forms. The opt-in language clearly discloses all message types, including both care-related communications and personalized promotional texts offering discounts on medications and services specific to the patient’s active treatment. It also states the message frequency cap of no more than 8 messages per month, that standard messaging rates may apply, and how to opt out at any time.

WHEN

Consent is collected at the time of patient registration and intake — before any SMS messages are sent. No SMS messages are sent to any individual prior to receiving documented written opt-in consent. For re-engaging lapsed patients, outreach is limited to patients who previously provided consent and have not opted out.

WHERE

Opt-in consent is obtained through the following channels:

- Online intake form at https://njweightloss.us (digital checkbox with timestamp recorded)

- In-office paper intake form at 428 Route 46 E., Suite #6, Fairfield, NJ 07004 (written patient signature)

- Patient portal profile settings

- Verbal confirmation followed by written documentation via care coordinator, retained in GoHighLevel CRM

HOW

The opt-in is a separate, clearly labeled written authorization — not a pre-checked box and not implied by any other agreement. The consent field contains the full disclosure language required by 10DLC standards (see Section 4 below). A copy of signed consent is retained in the patient record within our GoHighLevel CRM system. Compliance records are maintained by James Bock, Compliance Officer, reachable at Jbock@njweightloss.us.

COST

NJ Weight Loss does not charge patients for SMS communications. Standard message and data rates may apply per the patient’s mobile carrier plan. This is disclosed clearly in all opt-in language and in every message footer.

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Section 3: Sample Messages by Use Case

Use Case 1: Appointment Reminder

NJ Weight Loss: Hi [First Name], this is a reminder that your telehealth appointment is scheduled for [Date] at [Time]. To reschedule, call 856-630-7556. Reply STOP to opt out. Msg&Data rates may apply.

Use Case 2: Appointment Confirmation

NJ Weight Loss: Your appointment is confirmed for [Date] at [Time] with [Provider]. You’ll receive a video link 15 min before your call. Questions? Call 856-630-7556. Reply STOP to opt out.

Use Case 3: Prescription / Medication Status

NJ Weight Loss: Hi [First Name], your [Medication Name] prescription has been sent to [Pharmacy]. Estimated ship date: [Date]. Questions? Call 856-630-7556. Reply STOP to opt out. Msg&Data rates may apply.

Use Case 4: Lab / Bloodwork Results Ready

NJ Weight Loss: Hi [First Name], your recent lab results are ready. Please log into your patient portal or call 856-630-7556 to speak with your care team. Reply STOP to opt out. Msg&Data rates may apply.

Use Case 5: Bloodwork Required / TRT Compliance

NJ Weight Loss: Hi [First Name], your ongoing TRT/GLP-1 program requires updated bloodwork. Please schedule your labs by [Date] to avoid a pause in your prescription. Call 856-630-7556 or visit https://njweightloss.us. Reply STOP to opt out. Msg&Data rates may apply.

Use Case 6: Billing & Payment Notification

NJ Weight Loss: Hi [First Name], an invoice of $[Amount] is available for your recent visit or prescription. Pay securely at https://njweightloss.us or call 856-630-7556. Reply STOP to opt out. Msg&Data rates may apply.

Use Case 7: New Patient Onboarding

Welcome to NJ Weight Loss, [First Name]! Your care team is ready to support your journey. Your patient portal login was sent to your email. Need help? Call 856-630-7556. Reply STOP to opt out. Msg&Data rates may apply.

Use Case 8: Patient Re-Engagement (Lapsed Care)

NJ Weight Loss: Hi [First Name], we noticed it’s been a while since your last visit. We’d love to help you get back on track. Call us at 856-630-7556 or visit https://njweightloss.us to schedule. Reply STOP to opt out. Msg&Data rates may apply.

Use Case 9: Health & Wellness Educational Content

NJ Weight Loss: Hi [First Name], care tip: Consistent protein intake at each meal can significantly improve your GLP-1 results. Questions? Call 856-630-7556 or visit https://njweightloss.us. Reply STOP to opt out. Msg&Data rates may apply.

Use Case 10: Personalized Promotional Offer — GLP-1 Patients

Sent only to patients actively enrolled in a GLP-1 weight loss program who have consented to receive promotional texts.

NJ Weight Loss: Hi [First Name], as a current GLP-1 patient, you qualify for an exclusive discount on your next month’s semaglutide or tirzepatide program: [Discount Details]. Limited time. Call 856-630-7556 or visit https://njweightloss.us to redeem. Reply STOP to opt out. Msg&Data rates may apply.

Use Case 11: Personalized Promotional Offer — TRT Patients

Sent only to patients actively enrolled in a testosterone replacement therapy program who have consented to receive promotional texts.

NJ Weight Loss: Hi [First Name], we have a special offer for TRT patients this month: [Discount Details] on your next testosterone refill or add-on peptide therapy. Call 856-630-7556 to take advantage before it expires. Reply STOP to opt out. Msg&Data rates may apply.

Use Case 12: Personalized Promotional Offer — Peptide / Preventive Care Patients

Sent only to patients actively enrolled in a peptide or preventive care program who have consented to receive promotional texts.

NJ Weight Loss: Hi [First Name], your care team has a limited-time offer for patients on your program: [Offer Details]. Call 856-630-7556 or visit https://njweightloss.us to learn more. Reply STOP to opt out. Msg&Data rates may apply.

Use Case 13: Opt-Out Confirmation (Mandatory)

NJ Weight Loss: You have been unsubscribed and will no longer receive SMS messages from us. To re-subscribe, reply START. For care needs, call 856-630-7556. No further messages will be sent.

Use Case 14: Help Response (Mandatory)

NJ Weight Loss: For assistance, call 856-630-7556 or email Jbock@njweightloss.us. Reply STOP to unsubscribe at any time. Msg&Data rates may apply. Privacy Policy: https://njweightloss.us/privacy.html

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Section 4: Required Written SMS Opt-In Authorization Language

SMS COMMUNICATIONS AUTHORIZATION

By checking this box (or signing below), I authorize NJ Weight Loss and Preventive Care Clinics PA to send me automated text (SMS) messages to the mobile phone number I have provided. These messages may include:

- Appointment reminders and scheduling confirmations

- Prescription status and refill notifications

- Lab and bloodwork results and follow-up instructions

- Care coordination and provider follow-up messages

- Billing and payment notifications

- Health and wellness educational content related to my treatment

- Re-engagement messages if I have not completed my care program

- Personalized promotional text offers and discounts on medications and services specifically related to my active treatment program (e.g., GLP-1 weight loss medications, testosterone replacement therapy, peptide therapies, and preventive care services)

Message Frequency: Message frequency varies based on care activity. I will receive no more than 8 text messages per month.

Cost: Message and data rates may apply per my mobile carrier plan. NJ Weight Loss does not charge for SMS communications.

Opt-Out: I may opt out at any time by replying STOP to any message. I will receive one final confirmation and then no further SMS messages will be sent. To opt back in, I can reply START.

Help: I can reply HELP to any message for assistance, or contact NJ Weight Loss at 856-630-7556 or Jbock@njweightloss.us.

Privacy: SMS opt-in data and consent will not be shared with or sold to any third party for marketing or promotional purposes. My information is used solely to deliver communications from NJ Weight Loss. Full Privacy Policy: https://njweightloss.us/privacy.html

Providing my mobile number and consenting to receive SMS messages is voluntary and is not a condition of receiving medical services from NJ Weight Loss and Preventive Care Clinics PA.

[ ] I agree to receive SMS text messages from NJ Weight Loss at the mobile number provided.

Mobile Number: _______________________________ Date: _______________

Patient Signature: _______________________________ Printed Name: _______________

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Section 5: Required Privacy Policy Language for SMS Opt-In

Recommended Privacy Policy Section: “SMS Communications & Text Messaging”

SMS COMMUNICATIONS & TEXT MESSAGING

NJ Weight Loss and Preventive Care Clinics PA offers an optional SMS text messaging program to enrolled patients for care coordination, appointment management, prescription updates, and health communications. Participants who consent may also receive personalized promotional text messages offering discounts on medications and services specifically related to their active treatment program. Participation is entirely voluntary.

Opt-In Data: When you provide your mobile phone number and consent to receive SMS messages from NJ Weight Loss, that information is collected and stored securely as part of your patient record.

No Third-Party Sharing for Marketing: SMS opt-in data, including your mobile phone number and consent status, will not be shared with, sold to, or rented to any third party for marketing or promotional purposes. This data is used solely to deliver communications from NJ Weight Loss related to your care and account.

How We Use Your Mobile Number: Your mobile number may be used to send appointment reminders and confirmations, prescription and medication status notifications, lab and bloodwork results, care coordination follow-ups, billing and payment notifications, health and wellness educational content, program re-engagement messages, and personalized promotional text offers on medications and services related to your active treatment (e.g., GLP-1 medications, TRT, peptide therapies).

Message Frequency: You will receive no more than 8 SMS messages per month.

Opt-Out: You may opt out of SMS communications at any time by replying STOP to any message from NJ Weight Loss. You will receive a final confirmation, after which no further messages will be sent. To re-subscribe, reply START.

Data Retention: SMS consent records are retained as part of your patient record in compliance with applicable healthcare and telecom regulations.

Questions: Contact James Bock, Compliance Officer at Jbock@njweightloss.us or 856-630-7556.

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Section 6: Call-to-Action (CTA) Requirements & Checklist

|CTA Element |Required Language / Example |

|--------------------------------|-----------------------------------------------------------------------------------------------------------------------------------|

|Program/Brand Identity |“NJ Weight Loss” must be clearly identified as the sender on every CTA |

|Message Type Disclosure |Explicitly list all message types: care communications AND personalized promotional texts with medication/service discounts |

|Message Frequency |“You will receive no more than 8 messages per month.” |

|Cost Disclosure |“Msg & Data rates may apply.” |

|Opt-Out Instructions |“Reply STOP to cancel.” Must appear on every CTA and in every message. |

|Help Instructions |“Reply HELP for help.” Must appear on every CTA. |

|Separate Consent Checkbox |Must be unchecked by default. Never pre-checked. Never bundled with other consents. |

|No Condition of Service |“Consent is not a condition of receiving services from NJ Weight Loss.” |

|Privacy Policy Link |Hyperlink to https://njweightloss.us/privacy.html — must include statement that SMS opt-in data is not shared/sold to third parties|

|Terms & Conditions Link |Link to https://njweightloss.us/terms.html — must include SMS program terms |

|No Third-Party Sharing Statement|“SMS opt-in information will not be shared or sold to third parties for marketing purposes.” |

## Sample Compliant CTA Block (Website / Digital Form)

[ ] I agree to receive SMS text messages from NJ Weight Loss at the mobile number provided above.

NJ Weight Loss will send you appointment reminders, prescription notifications, lab updates, billing notices, care-related messages, and personalized promotional text offers on medications and services related to your treatment program. You will receive no more than 8 messages per month. Msg & Data rates may apply. Reply STOP at any time to cancel. Reply HELP for help.

SMS opt-in information will not be shared with or sold to third parties for marketing or promotional purposes.

Consent is not a condition of receiving services. Privacy Policy: https://njweightloss.us/privacy.html | Terms & Conditions: https://njweightloss.us/terms.html

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Section 7: Operational Notes & Compliance Reminders

- All opt-in records must be stored with timestamp, channel (web/paper/portal), and patient ID in GoHighLevel CRM.

- STOP, UNSTOP, START, CANCEL, END, QUIT, and HELP keywords must be handled automatically with compliant auto-responses (see Use Cases 13 & 14).

- Opt-out requests must be honored immediately — no further messages of any type after a STOP reply, including promotional texts.

- Do not exceed 8 messages per month per patient — this cap applies to the combined total of care messages AND promotional texts.

- Promotional/discount texts must be personalized and strictly limited to medications and services directly related to the patient’s active treatment program. Generic mass-marketing blasts to unrelated or unconverted contacts are not permitted under this campaign registration.

- Privacy Policy (https://njweightloss.us/privacy.html) and Terms & Conditions (https://njweightloss.us/terms.html) must be live and accessible at the time of 10DLC campaign registration.

- Healthcare SMS campaigns may receive additional carrier-level scrutiny. Avoid including specific drug dosages, clinical instructions, or language that implies diagnosis or treatment advice in SMS message bodies.

- All compliance inquiries should be directed to: James Bock, Compliance Officer, Jbock@njweightloss.us, 856-630-7556.

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NJ Weight Loss and Preventive Care Clinics PA | 420 Route 46 E., Suite #6, Fairfield, NJ 07004 | 856-630-7556 | https://njweightloss.us |

HIPAA NOTICE OF PRIVACY PRACTICES

1. Our Legal Duty

We are required by law to:

Maintain the privacy of your Protected Health Information (PHI)
Provide this Notice of Privacy Practices
Follow the terms currently in effect
Notify you in the event of a data breach involving your PHI

2. How We Use & Disclose Your Information

We may use your PHI for:

A. Treatment

To provide, coordinate, or manage your healthcare.

B. Payment

To obtain payment for services rendered.

C. Healthcare Operations

Quality assessment, licensing, compliance, and internal administration.

3. Uses Requiring Authorization

We will obtain written authorization before:

Marketing unrelated services
Selling PHI
Disclosing psychotherapy notes (if applicable)

You may revoke authorization in writing at any time.

4. Your Rights

You have the right to:

Request a copy of your medical record
Request corrections to your record
Request confidential communications
Request restrictions on disclosures
Receive an accounting of disclosures
File a complaint without retaliation

To exercise rights, contact:

Jbock@njweightloss.us
(908) 598-0509

You may also file a complaint with the U.S. Department of Health & Human Services.

5. Data Security

We use administrative, physical, and technical safeguards to protect PHI, including:

Secure electronic medical record systems
Encrypted communication where applicable
Limited staff access controls

No system is 100% secure, but we implement commercially reasonable safeguards.

SMS & ELECTRONIC COMMUNICATION POLICY

By providing your mobile phone number or email address, you consent to receive communications related to:

Appointment reminders
Lab reminders
Treatment follow-ups
Billing notifications
Practice announcements

1. SMS Consent

Message frequency varies.
Message & data rates may apply.
Consent is not required to receive medical services.
You may opt out at any time by replying STOP.
For assistance, reply HELP or call (908) 598-0509.

Patients Providing Express Permission To Receive SMS Messages have Provided Consent as Part of Onboarding Process and have agreed to (in a seperate signed written agreement):

I authorize NJ Weight Loss and Preventive Care Clinics PA to use automated text / SMS and pre-recorded messages to my cell phone or home phone to confirm appointments and inform me of special discounts and inform me of marketing specials. Standard fees from your cell phone provider apply. I can opt out of such services at any time. SENDING "STOP" to TEXT RECEIVED. NO DIFFERENCE IN SERVICES PROVIDED TO THOSE WHO DON'T SIGN UP FOR TEXTS.

2. Risks of Electronic Communication

Text messages and email may not be fully secure. By consenting:

You acknowledge the risk of unauthorized access.
You understand messages may contain limited PHI.
You accept responsibility for safeguarding your device.

3. Third-Party Platforms

We may use third-party vendors (e.g., CRM, scheduling, payment processing, SMS platforms) under Business Associate Agreements where required by HIPAA.

4. Revoking Consent

You may revoke SMS or email consent at any time by:

Replying STOP to text messages
Emailing Jbock@njweightloss.us
Calling (908) 598-0509

Revocation does not affect prior communications.

Contact Information

NJ Weight Loss & Preventive Care Clinics, PA
420 Route 46 E, Suite 6
Fairfield, NJ 07004
(908) 598-0509
Jbock@njweightloss.us
https://njweightloss.us