Notice of Privacy Practices
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.
Understanding Your Health Record/Information
This notice describes the practices of Glowline Sisters Beauty & Wellness, its healthcare providers and staff (collectively, “Provider”) with respect to your protected health information obtained and created while you are a patient of Provider.
Provider creates a record of the care and services you receive at Provider. Provider understands that medical information about you and your health is personal. Provider is committed to protecting medical information about you. This notice applies to all the records of your care at Provider. This notice will tell you how Provider may use and disclose medical information about you. It also describes your rights and certain obligations Provider has regarding the use and disclosure of medical information.
Your Health Information Rights
Although your health record is the physical property of Provider, the information belongs to you. You have the right to:
• Request a restriction on certain uses and disclosures of your information for treatment, payment and healthcare operations, and as to disclosures permitted to persons, including family members involved with your care and as provided by law. However, we are not required by law to agree to a requested restriction, unless the request relates to a restriction on disclosures to your health insurer regarding health care items or services for which you have paid out of pocket and in full;
• Obtain a paper copy of this notice of information practices;
• Inspect and request a copy of your health record as provided by law;
• Request that we amend your health record as provided by law. We will notify you if we are unable to grant yourrequest to amend yourhealth record;
• Obtain an accounting of disclosures of your health information as provided by law; and
• Request communication of your health information by alternative means or at alternative locations. We will accommodate reasonable requests.
You may exercise your rights set forth in this notice by providing a written request to Glowline Sisters Beauty & Wellnes: 1910 S Stapley Dr #120 Mesa AZ 86204.
Our Responsibilities
In addition to the responsibilities set forth above, we are also required to:
• Maintain the privacy of your health information;
• Subject to certain exceptions under the law, provide notice of any unauthorized acquisition, access, use or disclosure of your protected health information;
• Provide you with a notice as to our legal duties and privacy practices with respect to information we maintain about you;
• Abide by the terms of this notice; and
• Notify you if weare unable to agree to a requested restriction on certain uses and disclosures.
Provider reserves the right to change its practices and to make the new provisions effective for all protected health information Provider maintains, including information created or received before the change. Should Provider’s information practices change, Provider is not required to notify you, but Provider will have the revised notice available upon your request at Provider.
Uses and Disclosures of Medical Information that Do Not Require Your Authorization
The following categories describe different ways that we may use and disclose medical information without your authorization. We will explain what we mean for each category of uses or disclosures, but not every use or disclosure in a category will be listed. However, all the ways we are permitted to use and disclose information without your authorization should fall within one of the categories.
We will use your health information for treatment.
• For example: Provider may disclose medical information about you to doctors, nurses, technicians, medical students or other personnel who are involved in taking care of you. Provider may share medical information about you in order to coordinate different treatments, such as prescriptions and lab work. We also may provide your physician or a subsequent health care provider with copies of various reports to assist in treating you once you are discharged from care at Provider. We will use your health information for payment.
• For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures and supplies used. We will use your health information for regular health care operations.
• For example: Provider may use the information in your health record to assess the care and outcome in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the health care and services we provide.
We will use and disclose your health information as otherwise allowed by law. Examples of those uses and disclosures follow:
• Business associates: There are some services provided in our organization through agreements with business associates. Examples include answering services and copy services. To protect your health information, however, we require business associates to appropriately safeguard your information.
• Notification: Unless you object, we may use or disclose information to notify or assist in notifying a family member, a personal representative or another person responsible for your care about your location and general condition.
• Individuals involved in your care: Unless you object, we may disclose to a family member, another relative, a close personal friend or another person you identify, the health information that is directly relevant to that person's involvement in your health care or payment for your health care. If you are not able to agree or object to such disclosure, we may disclose the information as necessary if we determine it is in your best interest in our professional judgment.
• Disaster relief: We may use or disclose your health information to public or private disaster relief organizations to coordinate your care or to notify your family or friends of your location or condition in a disaster. We will provide you with an opportunity to agree or object to these disclosures when practical.
• Research: We may disclose information to researchers when their research has been approved by an institutional review board that has established protocols to protect the privacy of your health.
• Communications regarding treatment alternatives and appointment reminders: We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
• Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, medications, devices, supplements, products and product defects, or post marketing surveillance information to enable product recalls, repairs or replacement.
• Worker's compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to worker's compensation or other similar programs established by law.
• Public health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury or disability.
• Abuse, neglect or domestic violence: As required by law, we may disclose health information to a governmental representative authorized by law to receive reports of abuse, neglect or domestic violence.
• Judicial, administrative and law enforcement purposes: Consistent with applicable law, we may disclose health information about you for judicial, administrative and law enforcement purposes.
• Health oversight activities: We may disclose health information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections and licensure.
• Threats to health or safety: We may use or disclose health information as allowed by law if we believe in good faith that it is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public, or for law enforcement authorities to identify or apprehend an individual involved in a crime.
• Special government functions: We may disclose health information to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law, or for protective services to the President of the United States or certain other government officials. If you are a member of the military, we may disclose health information to military authorities under some circumstances. If you are an inmate of a jail, prison or other correctional facility or in the custody of law enforcement personnel, we may disclose health information necessary to maintain your health and the health and safety of others.
• Required or allowed by law: We will disclose medical information about you when required or allowed to do so by federal, state or local law.
• Electronic Health Information Exchange: Practice uses a third party to maintain our electronic medical records (EMR). Practice stores electronic health information about you in the EMR. Provider monitors who can view your EMR.
When We Need Your Written Authorization
We will not use or disclose your health information without your written authorization, except as described in this notice. Additional circumstances that might require your additional written authorization are not common, but an example would be uses and disclosures for marketing purposes.
For More Information or to Report a Problem
If you have questions and would like additional information, you may contact Provider at 480-788-7379. If you believe your privacy rights have been violated, you can send a complaint to Provider at 1910 S Stapley Dr #120 Mesa Arizona 85204, to the Secretary of Health and Human Services if appropriate, and Arizona State Department of Health. There will be no retaliation for filing a complaint.
This notice is effective on the following date: August 13, 2025
Provider may change its policies and this notice at any time and have those revised policies apply to all the protected health information it maintains. If or when Provider changes this notice, Provider will post the new notice at the office of each practice location where it can be seen.
Notice of Privacy Practices Acknowledgement
I, the undersigned, understand that under the Health Insurance Portability & Accountability Act of 1996 (HIPAA), I have certain rights to privacy regarding my protected health information.
I understand that this information can and will be used to:
• Conduct, plan and direct my treatment and follow-up among the multiple health care providers who may be involved in that treatment directly and indirectly;
• Obtain payment from third-party payers; and
• Conduct normal health care operations, such as quality assessments and physician certifications.
I acknowledge that I have been provided the Notice of Privacy Practices containing a more complete description of the uses and disclosures of my health information. I understand that Provider has the right to change its Notice of Privacy Practices from time to time and that I may contact this organization at any time at the address above to obtain a current copy of the Notice of Privacy Practices.
I understand that I may request in writing that Provider restrict how my protected health information is used or disclosed to carry out treatment, payment or health care operations. I also understand Provider is not required to agree to my requested restrictions, but if it does agree, then Provider is bound to abide by such restrictions.
I acknowledge that my medical information/records will be released to Provider. I further acknowledge that my medical information/records may be released from Provider to my primary care provider, referring/consulting providers and insurance company to process insurance claims. I also allow release of my medical information to the following individuals (i.e. family, caregivers, etc.)
TERMS OF SERVICE
Glowline Sisters Beauty and Wellness
Effective Date: 04/19/2026
1. INTRODUCTION
Welcome to Glowline Sisters Beauty and Wellness ("Company," "we," "our," or "us"). By accessing our website, booking services, or purchasing products, you agree to be bound by these Terms of Service ("Terms").
These Terms apply to all users, including clients receiving beauty, aesthetic, or medical services, and customers purchasing retail or e-commerce products.
2. SERVICES OFFERED
We provide a variety of mobile concierge and in-studio services, including but not limited to:
Beauty & Bridal Services
Wedding beauty services (on-site hair, makeup, and styling)
Bridal accessories including veils, hair clips, and pins
Group events such as Botox parties and beauty events
Esthetic Services
Facials and advanced skincare treatments
Waxing services
Lash, brow, and spray tanning services
Aesthetic & Medical Services
Botox and dermal fillers
IV hydration therapy
GLP-1 and other compounded medications
Dermatology compounded medications
Medical services are provided by licensed medical professionals or under medical supervision as required by law.
3. TELEHEALTH & MEDICAL CLEARANCE
Certain services require medical clearance through telehealth providers such as Qualiphy.
By booking medical services, you acknowledge:
You may be required to complete a telehealth consultation prior to treatment
Approval is determined solely by the licensed medical provider
Glowline Sisters does not guarantee approval for treatment
You are responsible for providing accurate medical history
Failure to disclose relevant health information may result in denial of service and/or increased risk.
4. CLIENT RESPONSIBILITIES
You agree to:
Provide accurate and complete health and personal information
Follow all pre- and post-care instructions
Disclose allergies, medications, and medical conditions
Be at least 18 years old for medical aesthetic services unless otherwise permitted by law
5. APPOINTMENTS, DEPOSITS & CANCELLATIONS
Deposits may be required to secure appointments or events
Deposits are non-refundable unless otherwise stated
Cancellations must be made within [Insert Hours] hours
Late cancellations or no-shows may result in fees or forfeiture of deposit
For group bookings (e.g., Botox parties, bridal events), additional contracts may apply.
6. RESULTS DISCLAIMER
Results from beauty and medical treatments vary by individual. We do not guarantee specific outcomes. Multiple sessions may be required.
7. MEDICAL DISCLAIMER
All medical aesthetic services carry inherent risks. By receiving services, you acknowledge:
Risks, benefits, and alternatives have been explained
You voluntarily consent to treatment
You understand that complications, though rare, may occur
8. PRODUCTS & E-COMMERCE
We offer retail and e-commerce products including:
Nuda self-tanning products
Skincare products via dropshipping (e.g., Skin Script, GlyMed+)
Bridal accessories (veils, clips, pins)
Product Terms
All sales are subject to availability
We reserve the right to modify pricing at any time
Product descriptions are provided for informational purposes only
Returns & Refunds
Due to hygiene and safety, skincare and beauty products may be non-returnable
Damaged or defective items must be reported within [Insert Days]
9. SHIPPING & DROP SHIPPING
Certain products are fulfilled through third-party suppliers. By purchasing:
You acknowledge shipping times may vary
We are not responsible for delays caused by carriers or suppliers
Risk of loss transfers upon delivery
10. EVENT & GROUP SERVICES
For Botox parties, bridal bookings, and group events:
A minimum number of participants may be required
A host may receive promotional pricing or incentives
Services are subject to space, safety, and medical eligibility
11. PAYMENT TERMS
Payment is due at time of service unless otherwise agreed
We accept [Insert Payment Methods]
Failure to pay may result in denial of future services
12. LIABILITY WAIVER
To the fullest extent permitted by law:
Glowline Sisters is not liable for adverse reactions due to undisclosed conditions
We are not responsible for allergic reactions to products
Clients assume all risks associated with services received
13. INTELLECTUAL PROPERTY
All content on our website, including branding, images, and materials, is owned by Glowline Sisters and may not be used without permission.
14. PRIVACY
Your use of our services is also governed by our Privacy Policy. We take reasonable steps to protect your personal and medical information.
15. MODIFICATIONS
We reserve the right to update these Terms at any time. Continued use of our services constitutes acceptance of any changes.
16. GOVERNING LAW
These Terms are governed by the laws of the State of Arizona.
17.Mobile Terms of Service
Messages related to your account, orders, services, appointment reminders, marketing and promotional messages may be received. Frequency may vary.
You can cancel the SMS service at any time by texting “STOP.” After you send “STOP,” we will confirm your unsubscribe via SMS. After this, you will no longer receive messages from us. If you would like to opt back in, you may sign up again as you did previously.
If you are experiencing issues with the messaging program, reply with the keyword “HELP” for assistance, or contact us directly at booking@glowlinesisters.com or 480-788-7379
Carriers are not liable for delayed or undelivered messages.
Message and data rates may apply for any messages sent to you from us and from you to us. Message frequency may vary. For questions about your text or data plan, please contact your wireless provider.
18. CONTACT INFORMATION
Glowline Sisters Beauty and Wellness
booking@glowlinesisters.com
1910 S. Stapley Dr #120
Mesa Arizona, 85203
IMPORTANT MEDICAL NOTICE
If you are experiencing a medical emergency, call 911 immediately. Our services are not a substitute for primary medical care.