HIPAA Notice of Privacy Practices

Effective date: September 19, 2025

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information (PHI), provide you with this Notice, and follow the duties and privacy practices described here. We will notify you if a breach occurs that may have compromised the privacy or security of your PHI.

Your Rights

You have the right to:

• Get a copy of your record (paper or electronic) and many of the disclosures we have made.
• Ask us to correct health information you think is incorrect or incomplete.
• Request confidential communications (for example, contact you at a different address or phone).
• Ask us to limit what we use/share (we’ll consider your request; we’re not required to agree except for certain out-of-pocket payment requests).
• Get a list (accounting) of disclosures we’ve made other than for treatment, payment, and operations.
• Get a paper copy of this Notice at any time.
• Choose a representative (someone who has medical power of attorney or is your legal guardian).

To exercise these rights, contact us using the information in the “Contact Us” section below. We will respond within the timeframes required by law.

How We May Use and Disclose Your Information

Treatment, Payment, and Health Care Operations (TPO)

• Treatment: share information with other providers to coordinate your care.
• Payment: submit claims, verify benefits, obtain prior authorizations, and manage billing.
• Operations: quality assessment, training, licensing, audits, and practice management.

Other Uses and Disclosures Permitted or Required by Law

• Public health & safety: reporting adverse events, preventing disease, product recalls.
• Health oversight & law enforcement: inspections, investigations, subpoenas, court orders.
• Research: as permitted by law and with required approvals/waivers.
• Workers’ compensation, disability, and similar programs.
• Coroners, medical examiners, and funeral directors as necessary to carry out their duties.
• To avert a serious threat to health or safety, when allowed by law.
• Specialized government functions (e.g., military or national security), when applicable.

Uses and Disclosures that Require Your Authorization

We will obtain your written authorization for uses/disclosures not described in this Notice, including most uses of psychotherapy notes, certain marketing communications, and disclosures that constitute a sale of PHI. You may revoke an authorization at any time in writing, except to the extent we have already acted in reliance on it.

Your Choices

You may tell us your preferences about what we share (for example, sharing with a family member involved in your care, or leaving messages at a certain number). If you are not able to tell us your preference, we may go ahead and share if it is in your best interest and permitted by law.

Communication Preferences

By providing your email or phone number, you consent to receive messages related to your care, appointments, and clinic updates. Standard carrier rates may apply for SMS. You may opt out of non-essential communications at any time (reply STOP to SMS, or use the unsubscribe link in email).

Minors and Personal Representatives

If you are a minor or have a personal representative, we will follow applicable laws regarding consent and access to records.

Breach Notification

We will promptly notify you, consistent with law, if there is a breach of your unsecured PHI.

Changes to This Notice

We may change the terms of this Notice and the changes will apply to all information we have about you. The new Notice will be available upon request and posted on our website.

Questions or Complaints

If you have questions, want to exercise your rights, or believe your privacy rights have been violated, contact us. You can also file a complaint with the U.S. Department of Health & Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

This Notice summarizes how we may use/share information and your rights. Certain state laws may provide additional protections; where they are more protective, we will follow them.